文章摘要
潘德盛,顾澄宇,蔡〓兵,王〓彤,吴鸣宇.腹腔镜与开腹胆总管探查一期缝合术的对比[J].南京医科大学学报,2010,(6):814~817
腹腔镜与开腹胆总管探查一期缝合术的对比
A comparative study on primary closure of the common bile duct by open and laparoscopic surgery in treatment of choledocholithotomy
投稿时间:2010-02-19  
DOI:10.7655
中文关键词: 腹腔镜  开腹手术  胆总管结石  一期缝合
英文关键词: laparoscopy  laparotomy  choledocholithiasis  primary suture
基金项目:
作者单位
潘德盛 南京医科大学附属无锡市人民医院肝胆外科,江苏 无锡〓214023 
顾澄宇  
蔡〓兵  
王〓彤  
吴鸣宇  
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中文摘要:
      目的:探讨腹腔镜胆总管探查一期缝合术与开腹胆总管探查一期缝合术治疗胆总管结石的临床效果?方法:回顾性分析本院自2006年1月~2008年8月期间86例胆总管结石病例,其中腔镜组30例,开腹组56例,比较两种术式的手术相关情况(胆总管直径?结石大小?结石数目?手术时间和术中出血量)?术后恢复情况(首次肛门排气?腹腔引流时间及住院时间)?住院费用?术后并发症(胆漏?腹腔出血?切口感染?肺部感染?结石残余)等?结果:两组病例均治愈出院,无手术死亡,无术后腹腔出血?肺部感染并发症发生;术后胆漏?切口感染及结石残余,两组无明显差异(P > 0.05);在术中出血量?首次肛门排气?术后腹腔引流时间及术后住院天数,腔镜组优于开腹组(P < 0.05);但腔镜组的手术时间较长,且住院费用高于开腹组(P < 0.05)?结论:腔镜组手术时间延长但术后恢复较快;开腹组住院费用较低,适应范围较腔镜组广;并发症发生率两组相仿?
英文摘要:
      Objective:To investigate the clinical results of primary closure of the common bile duct(CBD)by open and laparoscopic surgery in treatment of choledocholithotomy. Methods:A total of 86 patients with primary closure after the CBD exploration between January,2006 and August,2008 were enrolled,including 30(35%)umdergone laparoscopic choledochotomy(laparoscopic group)and 56(65%)received open choledochotomy(open group). The clinical data in the two groups were analyzed comparatively. Results:The patients of two groups were cured to discharge from hospital. No mortality and no complications such as postoperative bleeding or pulmonary infection occurred in two groups. There was no significant difference in bile duct retained stones,postoperative infection and bile leakage between two groups. On the volume of intraoperative bleeding,time of gastrointestinal recovery,abdominal drainage and postoperative stay,the laparoscopic group was much superior to the open group(P < 0.05). However,the laparoscopic group had a longer operation time and a higher hospital expense than the open group. Conclusion:Laparoscopic group has a better postoperative recovery but a longer operation time. Comparatively,the open group with wider range of indication has a lower cost of treatment and is similar with the laparoscopic group in the incidence of postoperative complications.
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