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Received:March 28, 2022 Published Online:January 20, 2023
Received:March 28, 2022 Published Online:January 20, 2023
中文摘要: 目的探讨腹腔镜胆总管探查一期缝合术的安全性和有效性。
方法回顾性分析2020年1月至2021年12月在南京医科大学附属逸夫医院普外科收治胆囊结石合并胆总管结石拟行腹腔镜胆总管探查（LCBDE）一期缝合术的36例患者的临床资料。
结果30例患者顺利完成LCBDE一期缝合，1例患者术中行内镜逆行胰胆管造影，5例患者术中放置T管。完成LCBDE一期缝合患者的手术时间55～180（105.77±36.30）min，术后住院时间5～16（7.00±2.07）d。患者术后丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、γ-谷氨酰转肽酶、总胆红素、直接胆红素均较术前显著下降，差异有统计学意义（P＜0.01）。1例患者术后出现胆漏，保持腹腔引流通畅，术后11d治愈。
结论LCBDE一期缝合术在临床上治疗胆囊结石合并胆总管结石是切实可行的，安全有效的，其技术要点在于确保胆管内无结石残留。
Abstract:ObjectiveToinvestigatetheclinicaleffectandsafetyoflaparoscopiccommonbileductexploration（LCBDE）andprimarysutureofcommonbileduct.
MethodsAretrospectiveanalysiswasperformedontheclinicaldataof36patientsundergoingLCBDEandprimaryductsutureintreatingcholecystolithiasiscomplicatedwithcholedocholithiasisintheSirRunRunHospitalofNanjingMedicalUniversityfromJanuary2020toDecember2021.
ResultsLCBDEwithprimarysuturewassuccessfullyperformedin30patients,ERCPwasconductedinonepatientduringoperation,andTtubewasplacedin5patients.InthepatientswithLCBDEandprimarysuture,theoperationtimewas55-180（105.77±36.30）min,thepostoperativehospitalstaywas5-16（7.00±2.07）days,andthelevelsofalanineaminotransferase,aspartatetransaminase,gamma-glutamyltransferase,totalbilirubinanddirectbilirubindecreasedsignificantlycomparedwiththosebeforeoperation（P＜0.01）.Onepatienthadbileleakageafteroperationandwascured11daysafterabdominalcavityunobstructeddrainage.
ConclusionInthetreatmentofcholecystolithiasiscomplicatedwithcholedocholithiasis,LCBDEandprimarysutureissafeandeffective,anditstechnicalkeypointistoensurethatthereisnoresidualstoneinthebileduct.
keywords: Cholecystolithiasis Choledocholithiasis Laparoscopiccommonbileductexploration Primaryductsuture
文章编号： 中图分类号：R657.4+2 文献标志码：B
基金项目:
| Author Name | Affiliation |
| ZHOUYang-chun,PANYue,ZHUFeng | DepartmentofGeneralSurgery,SirRunRunHospitalofNanjingMedicalUniversity,Nanjing,Jiangsu211166,China |
| Author Name | Affiliation |
| ZHOUYang-chun,PANYue,ZHUFeng | DepartmentofGeneralSurgery,SirRunRunHospitalofNanjingMedicalUniversity,Nanjing,Jiangsu211166,China |
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