CAJ | 학술논문

目的：探讨腹腔镜胆总管切开取石一期缝合的可行性及临床应用价值。方法总结2008年9月-2013年5月54例胆总管切开取石一期缝合的临床资料(观察组），与同期行腹腔镜胆总管切开取石T管引流97例（对照组）进行临床效果对比分析。结果一期缝合组较T管引流组的术后疼痛轻、胃肠道功能恢复快、住院时间短、临床费用低(P＜0.05)，两组手术时间及术中出血量差异无统计学意义(P＞0.05)，均无胆漏、胆管狭窄、结石残留等并发症及再次手术发生。结论腹腔镜胆总管切开取石一期缝合安全可行，具有微创、康复快、疼痛轻、住院时间短、临床费用低等优点，但应注意适应证的选择，术中需精细、规范操作。
목적：탐토복강경담총관절개취석일기봉합적가행성급림상응용개치。방법총결2008년9월-2013년5월54례담총관절개취석일기봉합적림상자료(관찰조），여동기행복강경담총관절개취석T관인류97례（대조조）진행림상효과대비분석。결과일기봉합조교T관인류조적술후동통경、위장도공능회복쾌、주원시간단、림상비용저(P＜0.05)，량조수술시간급술중출혈량차이무통계학의의(P＞0.05)，균무담루、담관협착、결석잔류등병발증급재차수술발생。결론복강경담총관절개취석일기봉합안전가행，구유미창、강복쾌、동통경、주원시간단、림상비용저등우점，단응주의괄응증적선택，술중수정세、규범조작。
Objective To investigate the feasibility and clinical value of laparoscopic choledocholithotomy with primary suture. Methods The clinical data of 54 patients suffered from choledocholithiasis (observation group) underwent laparoscopic choledo-cholithotomy with primary suture from September, 2008 to May, 2013 were summarized. And 97 cases underwent laparoscopic choledocholithotomy T-tube drainage during the same period were selected as the control group. The clinical effects were com-pared between the two groups. Results Compared with the T-tube drainage group, the primary duct closure group had less pain, faster recovery of gastrointestinal function, shorter postoperative hospital stay and less hospital costs(P<0.05). There was no signifi-cant difference in the operation time and intraoperative blood loss between the two groups(P>0.05);There was no bile leakage, bile duct stricture, residual stones and reoperation in all the patients.Conclusion Laparoscopic choledocholithotomy with primary suture is safe and feasible. It has the advantages such as minimal invasion, quick recovery, little pain, short hospital stay and low cost . However, the selection of indications should be noted and the surgery needs to be finely and standardly operated.