临床外科杂志 ›› 2021, Vol. 29 ›› Issue (2): 181-183.doi: 10.3969/j.issn.1005-6483.2021.02.025

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双镜联合治疗胆总管结石术中不同一期缝合方式对病人的疗效及预后的影响评估

  

  1. 解放军联勤保障部队第988医院普通外科
  • 出版日期:2021-02-20 发布日期:2021-02-20

Analysis of curative effect and prognosis of two suture methods of laparoscopic common bile duct exploration in the treatment of gallbladder and common bile duct stone patients

  • Online:2021-02-20 Published:2021-02-20

摘要: 目的:探讨双镜联合治疗胆总管结石术中不同一期缝合方式对病人的疗效及预后的影响。方法:胆囊结石合并胆总管结石病人68例,根据术中胆总管缝合方式分为研究和对照组,每组各34例,对照组采用薇乔线间断缝合,研究组采用倒刺线连续缝合,比较两组病人的临床疗效的差异。结果:除术中出血量外,研究组病人的手术时间、留置引流管时间及住院时间均优于对照组,差异有统计学意义(P<0.05);术后研究组病人的血清白细胞介素(IL)6、C反应蛋白(CRP)及肾上腺素(EP)均好于对照组,差异有统计学意义(P<0.05);术后研究组病人的总并发症发生率低于对照组,差异有统计学意义(P<0.05);两组病人半年后的结石复发率比较差异无统计学意义(P>0.05)。结论:双镜联合治疗胆总管结石术中采用倒刺线连续一期缝合胆总管的疗效更佳显著且安全,降低胆漏的发生率,减轻炎性反应程度。

关键词: 腹腔镜, 胆道镜, 胆总管结石, 连续缝合, 间断缝合, 疗效, 预后

Abstract: Objective:To investigate the analysis of Curative effect and prognosis of two suture methods of laparoscopic common bile duct exploration in the treatment of gallbladder and CBD stone patients.Methods:To screening 68 cases of gallbladder and CBD stone patients as research subjects,it will be divided into study group with 34 cases and control group with 34 cases,patients in control group were given vicryl interrupted suture of laparoscopic common bile duct exploration,patients in study group were given Barbed wire continuous suture of laparoscopic common bile duct exploration,then the two groups were compared in terms of clinical efficacy and so on.Results:In addition to intraoperative blood loss,the operation time,indwelling drainage tube time and hospital stay time of the study group were all better than those of the control group(P<0.05).The serum IL6,CRP and EP of the patients in the study group were better than those in the control group(P<0.05).The incidence of total complications in the study group was significantly lower than that in the control group(P<0.05).There was no difference between the two groups in stone recurrence rate after half a year(P>0.05).Conclusion:The Barbed wire continuous suture of laparoscopic common bile duct exploration in the treatment of gallbladder and CBD stone patients is significant and safe, reduce the incidence of bile leakage, reduce the degree of inflammatory reaction.

Key words: aparoscopy, choledochoscopy, common bile duct stones, continuous suture, intermittent suture, curative effect, prognosis

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