摘要： 目的 探讨经脐单切口腹腔镜胆囊切除、胆总管切开取石一期缝合治疗胆囊结石并发胆总管结石的临床效果。方法 选取2010年1月至2017年12月在我院行胆囊结石并发胆总管结石手术治疗的患者，行单切口腹腔镜胆囊切除、胆总管切开取石一期缝合（一期缝合组） 42例，行腹腔镜胆囊切除、胆总管切开取石留置T型管引流（T管引流组） 40例。记录手术时间、并发症、住院时间及手术成功率等。结果 2组患者手术成功率均为100%。一期缝合组手术时间略长于T管引流组，但差异无统计学意义。一期缝合组平均住院时间短于T管引流组，差异有统计学意义（P < 0.05）。2组术后胆瘘、出血、结石残留、结石复发情况比较无统计学差异。结论 单切口腹腔镜胆囊切除、胆总管切开取石一期缝合对于部分胆囊结石并发胆总管结石患者是一种有效的治疗方法。

单切口腹腔镜胆总管探查取石一期缝合临床疗效分析

宫瑜

中国医科大学附属盛京医院普通外科, 沈阳 110004

收稿日期:2021-09-22出版日期:2022-04-20发布日期:2022-05-05
通讯作者:宫瑜E-mail:gongy@sj-hospital.org
作者简介:宫瑜(1983-),女,主管护师,本科.



关键词: 胆囊结石, 胆总管结石, 腹腔镜胆囊切除
Abstract: Objective To explore the safety and effectiveness of the T-tube-free single-incision laparoscopic common bile duct exploration plus cholecystectomy technique for the treatment of choledocholithiasis. Methods Two patient groups treated for choledocholithiasis at our hospital between January 2010 and December 2017 were selected for analysis. Forty-two patients (primary suture group) had undergone T-tube-free single-incision laparoscopic common bile duct exploration plus cholecystectomy,whereas 40 (T-tube drainage group) had been treated with single-incision laparoscopic common bile duct exploration and stone removal with T-tube drainage. Operational success rate,surgical method,operative time,complications,and hospital stay were evaluated. Results Both groups had a 100% operational success rate. Although the primary suture group's operation time was slightly longer than that of the T-tube drainage group,but there was no significant difference. However,the average length of hospital stay was significantly lower in the primary suture group than in the T-tube drainage group. No significant difference between the two groups was found in terms of postoperative biliary fistulas,residual stones,and stone recurrence. Conclusion T-tube-free single-incision laparoscopic common bile duct exploration plus cholecystectomy is a safe and effective method for the treatment of choledocholithiasis.
Key words: gallbladder stones, choledocholithiasis, laparoscopic cholecystectomy
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