【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. ...... 如果您在使用手机等流览时无法查看或下载全文，可能是被搜索引擎失真“转码”，请点击屏幕最下方的“电脑版”或“原网页”访问。


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