摘要【目的】探讨腹腔镜下经胆囊管汇入部微切开的改良胆道缝合技术对胆石症的治疗效果的影响。【方法】选取2013年3月至2016年8月本院行经胆囊管汇入部微切开手术的167例胆石症患者的临床资料。将采用改良胆道缝合技术联合腹腔镜胆总管探查术(LCBDE)的病例设为观察组( n =101),将行LCBDE常规术缝合者设为对照组( n =66)。观察比较两组手术情况及术后并发症发生情况。【结果】观察组术后住院天数显著低于对照组,差异有统计学意义( P <0.05);两组手术时间、T管引流率比较,差异无统计学意义( P >0.05)。所有患者均接受随访,期间均无胆管狭窄、结石复发等事件发生。观察组有1例术后d5发生胆漏,行十二指肠镜下乳头括约肌切开术(EPT)和鼻胆管引流术(ENBD)。对照组有6例患者术后发生胆漏,均行急诊开腹探查术,发现其微切开裂开呈现唇状,加固缝合后放置T管引流。观察组术后胆漏的发生率显著低于对照组,差异有统计学意义( P <0.05);两组术后切口感染、再发黄疸发生率比较,差异无统计学意义( P >0.05)。【结论】经胆囊管汇入部微切开改良胆道缝合技术应用于胆石症治疗能显著降低术后胆漏的发生风险,缩短患者术后住院时间,临床效果较好。
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2018, Vol. 35 
