【摘要】 目的:探讨单向免打结倒刺线在腹腔镜胆道探查一期缝合术中的临床效果及安全性。方法:回顾分析2016年1月至2018年1月由同一主刀医师完成的96例腹腔镜胆道探查一期缝合术的临床资料,患者分为对照组(n=47,采用普通可吸收线缝合)与观察组(n=49,采用单向免打结倒刺线缝合),比较两组胆总管缝合时间、总手术时间、术中出血量、术后住院时间、术后24 h疼痛评分及术后并发症(胆漏、胆道残留结石、肺部感染、术后急性胰腺炎)的发生情况。结果:两组均顺利完成手术,无中转开腹及严重并发症发生。两组术中出血量、术后住院时间、胆漏、胆道残余结石、肺部感染、术后急性胰腺炎及术后24 h疼痛评分差异均无统计学意义(P>0.05)。观察组胆管缝合时间、总手术时间短于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜胆道探查一期缝合术中采用单向免打结倒刺线可降低手术难度,缩短手术时间,提高手术效率,且不增加围手术期并发症发生率。更多还原

【Abstract】 Objective:To evaluate the safety and efficacy of unidirectional knotless barded suture for primary closure after laparoscopic common bile duct exploration(LCBDE).Methods:From Jan.2016 to Jan.2018,the clinical data of 96 patients with common bile duct stones who underwent LCBDE by the same surgeon were retrospectively analyzed.These patients were divided into normal absorbable suture group(n=47) and unidirectional knotless barded suture group(n=49).Time of common bile duct suture closure,overall operation time,blood loss,postoperative hospitalization duration,24-h postoperative pain scores and postoperative complications(bile leakage,residual bile duct stones,pulmonary infection,and postoperative acute pancreatitis) were recorded and compared between the two groups.Results:The operations of both groups were performed successfully without serious intraoperative complications or conversion to open surgery.The differences of intraoperative blood loss,postoperative hospitalization duration,bile leakage,residual bile duct stone,pulmonary infection,postoperative acute pancreatitis and 24-h postoperative pain scores were not significant between the two groups(P>0.05).Time of common bile duct suture closure and overall operation time in unidirectional knotless barded suture group were less than those in normal absorbable suture group(P<0.05).Conclusions:The application of unidirectional knotless barded suture is safe and effective for primary common bile duct closure after LCBDE.It could reduce the difficulty of laparoscopic operation,shorten operation time,improve the efficiency of operation and dose not increase the incidence of perioperative complications.更多还原