中国实用外科杂志

中国实用外科杂志

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腹腔镜胆总管探查即时缝合术885例报告

索运生，陈安平，肖    宏，陈先林   

  1. 成都市第二人民医院肝胆胰外科，四川成都 610017
  • 发布日期:2012-01-18

  • Published:2012-01-18

摘要：

目的    总结运用腹腔镜胆总管探查即时缝合术的治疗经验。 方法    对1992年6月至2008年12月成都市第二人民医院运用腹腔镜胆总管探查即时缝合术885例的临床资料进行分析。 结果    837例手术成功，4例胆总管残石经内镜取石治愈，4例肝内胆管残石未处理，37例胆漏经腹腔引流管、腹腔镜、内镜或开腹引流治愈，2例术后出血，1例胰头癌病人术后死亡，其他并发症均经非手术综合治疗痊愈。 结论    选择合适病例，腹腔镜胆总管探查即时缝合术是安全可行的。

关键词: 腹腔镜, 胆总管探查术, 即时缝合

Abstract:

Primary closure of bile duct incision of laparoscopic bile duct exploration: a report of 885 cases        SUO Yun-sheng, CHEN An-ping, XIAO Hong, et al. Department of Hepatopancreatobiliary Surgery, the Second People’s Hospital of Chengdu City, Chengdu 610017, China
Corresponding auther: SUO Yun-sheng，E-mail:yunshengsuo5230@sina.com
Abstract    Objective    To summarize the experience on laparoscopic choledochotomy with primary suture. Methods The clinical data of 885 cases of laparoscopic choledochotomy with primary suture performed from June 1992 to December 2008 in the Second People’s Hospital of Chengdu City were analyzed. Results    It had obtained successful in 837 out of 885 cases. Four cases had residual stones then were cured with endoscopic sphincterotomy. Four cases had residual stones then were not cured with endoscopy. Thirty-seven cases of bile leakage were cured through patent drainage, laparoscopiy, endoscopy and open abdominal operation. Hemorrhage occurred in 2 cases. One case of pancreatic head carcinoma died in postoperation 15 days. Conclusion    Laparoscopic choledochotomy with primary closure is safe and effective in the hands of skilled endoscopiest for suitable cases.

Key words: laparoscopy, common bile duct exploration, primary closure