CAJ | 학술논문

目的探讨运用腹腔镜联合纤维胆道镜对肝外胆管结石进行切开探查取石及一期缝合的治疗方法.方法分析选择性运用腹腔镜联合胆道镜探查取石一期缝合治疗肝外胆管结石113例(腹腔镜组)及开腹胆总管切开探查取石一期缝合治疗肝外胆管结石141例(开腹组),两组患者的手术经过及预后情况.结果两组所有患者手术均获成功,腹腔镜组无中转开腹.腹腔镜组术后发生胆瘘3例(2.7％),开腹组术后发生胆瘘4例(2.8％),两组胆瘘发生率比较差异无统计学意义(P＞0.05).两组患者中首次肛门排气时间腹腔镜组为(2.00±0.11)d,开腹组为(2.66±0.09)d,差异有统计学意义(P＜0.05);腹腔镜组术后住院时间为(7.39±0.14)d,开腹组为(8.98±0.33)d,差异有统计学意义(P＜0.05).结论严格选择性运用腹腔镜联合胆道镜探查取石一期缝合安全可行.
목적 탐토운용복강경연합섬유담도경대간외담관결석진행절개탐사취석급일기봉합적치료방법.방법 분석선택성운용복강경연합담도경탐사취석일기봉합치료간외담관결석113례(복강경조)급개복담총관절개탐사취석일기봉합치료간외담관결석141례(개복조),량조환자적수술경과급예후정황.결과 량조소유환자수술균획성공,복강경조무중전개복.복강경조술후발생담루3례(2.7％),개복조술후발생담루4례(2.8％),량조담루발생솔비교차이무통계학의의(P＞0.05).량조환자중수차항문배기시간복강경조위(2.00±0.11)d,개복조위(2.66±0.09)d,차이유통계학의의(P＜0.05);복강경조술후주원시간위(7.39±0.14)d,개복조위(8.98±0.33)d,차이유통계학의의(P＜0.05).결론 엄격선택성운용복강경연합담도경탐사취석일기봉합안전가행.
Objective To summarize the experiences of primary closure after laparoscopic common bile duct exploration (LCBDE).Methods 113 patients in LCBDE group were studied,who underwent LCBDE combined with choledochoscopy for extrahepatic bile duct stones.After LCBDE,the choledochotomy was closed by primary closure.141 patients in open surgery group were studied,who underwent open common bile duct exploration (CBDE) combined with choledochoscopy for extrahepatic bile duct stones.After CBDE,the choledochotomy was closed by primary closure.Results There was no mortality and bile duct injury.In LCBDE group,none of them was converted to open surgery and experienced postoperative complications,and residual stone.Postoperative bile leak occurred in 3 patients (2.7％) in group LCBDE and 4 patients (2.8％) in open surgery group,respectively (P ＞ 0.05).The time of the first nostonerative aerofluxus shorter in group L [(2.00 ± 0.11) d] than in group O [(2.66 ± 0.09) d,P ＜ 0.05].The hospital stay was significantly shorter in group L [(7.39 ±0.14) d] than in group O [(8.98 ±0.33) d,P ＜ 0.05].Conclusion Primary closure after laparoscopic common bile duct exploration combined with choledochoscopy is safe and effective for the management of extrahepatic bile duct stones,and can be performed selectively in qualified hospitals.