【摘要】 目的：探讨腹腔镜胆总管切开取石一期缝合术的优点、方法及适应证。方法：应用腹腔镜手术设备及纤维胆道镜为29例胆总管结石患者行腹腔镜胆总管切开取石术，不置T管引流,一期缝合胆总管壁。结果：26例手术成功,平均手术时间982min,术中平均出血153ml,术后平均肛门排气时间196h,术后平均住院83d,无胆漏等严重并发症发生,3例中转行腹腔镜胆总管切开取石T管引流术。结论：应用腹腔镜胆总管切开取石一期缝合术治疗胆管结石具有创伤小、住院时间短及并发症少的优势,对符合适应证的患者是一种安全、有效的术式 ,但应掌握操作技巧以提高手术成功率、防止胆漏的发生。

    【关键词】 胆总管结石;腹腔镜；一期缝合

    Evaluation of laparoscopic choledochotomy and primary ductal submucosa closure：with a report of 29 cases

    ZHU Huiru,CHEN Jingfan,YI Xinping,et al.

    Dept.of Hepatobiliary Surgery,Liuzhou Traditional Chinese Medical Hospital,Liuzhou 545001,China

    【Abstract】 Objective:To explore the value,method and indication of laparoscopic choledochotomy and primary ductal submucosa closure.Methods:The clinical data of twentynine patients with common bile duct calculi underwent laparoscopic choledochotomy and primary ductal submucosa closure without routine Ttube drainage was retrospectively analyzed.Results:Twentysix cases were successfully accomplished the operation but 3 cases converted to Ttube drainage.The mean operating time,blood loss and postoperative hosptalization were 98.2min,15.3ml and 8.3d respectively.There were no severe complications occured in the patients who underwent primary closure.Conclusions:Laparoscopic choledochotomy and primary ductal submucosa closure has the advantage of less invasion,less complication and shorter hospitalization.It is a safe and effective operation for patients who have the indication. ...... 婵犵鈧啿鈧綊鎮樻径鎰畺闁靛ǹ鍎查煬顒€霉閿濆牊纭堕柡浣靛€濋獮宥団偓锝庡亝缁ㄦ氨绱掑☉姗嗘Ч缂佷緤濡囬幉鎾醇閻斿壊妲梺鍝勫暟婵數娑甸崼鏇炶摕闁靛／鍕暯闂佺懓鐡ㄩ悧鏃傜箔閸涱喗濮滈柦妯侯槸瀵潡鏌￠崒姘カ缂佽鲸绻堝畷锝夘敍濠靛棗骞嬮梺鍝勫閸ㄧ敻锝為敃鍌氱婵犲﹤鎳庨崑宥団偓娈垮枟濞叉﹢骞栭崨濠傜窞閺夊牃鏅滈崺鍌炴煃閵夛妇鐭庢繛鏉戞閹秵鎷呭ù瀣壕婵犲灚鎸剧粈澶愭偣閸ヮ剦妫戦柛瀣剁秮瀹曟瑧鎷犻懠顒佺秳濡ょ姷鍋炲ú妯恒€掗懜鐢碘枖閻庯綆鍋呴悡娆撴煟閵娿儱顏ら柍褜鍓氱划搴ㄥ极閹间焦鍤囬柟瀵稿Т椤ｅジ鏌嶉妷锔剧畺闁搞劊鍔戦崹鎯р堪閸愩劍鏋剧紓鍌氬暞閸ㄥ潡濡存径鎰伋婵犻潧饪撮崯蹇涙⒒閸屻倕鏋旈柍褜鍓ㄩ幏锟�


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