资源描述：
《腹腔镜胆总管切开取石不同缝合方式对术中夹闭T管致胆漏的影响_王梦钦》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、第20卷第12期中国内镜杂志Vol.20No.122014年12月ChinaJournalofEndoscopyDec.2014文章编号：1007-1989（2014）12-1322-05腹腔镜胆总管切开取石不同缝合方式对术中夹闭T管致胆漏的影响122322王梦钦，石玉宝，鲁蓓，李维军，董万斌，王新波（1.河北北方学院，河北张家口075000；2.河北北方学院附属第二医院普外科，河北宣化075100)；3.河北省阳原县人民医院，河北阳原075800）摘要：目的探讨腹腔镜胆总管切开取石术术中夹闭T管的可行性及其与胆总管缝合方式的关系。方法选择腹腔镜胆总管切开取石置T管患者152
2、例，随机分为3组，分别采取不同的胆总管缝合方法，术中夹闭T管。观察3组患者术中、术后胆总管内压变化及胆漏情况。结果胆漏发生率分别为3~0可吸收线间断缝合组13例（26.00%），3~0可吸收线连续缝合组9例（16.98%），3~0V-lock线连续缝合组0例，差异有显著性（P<0.05）。全部胆漏经腹腔引流痊愈；全组术后无肝外胆管狭窄，无其他严重并发症及死亡。结论腹腔镜胆总管切开取石术中夹闭T管安全、可行，以3~0V-lock线连续缝合可有效避免术后胆总管压力增高引发胆漏的风险。关键词：腹腔镜；胆总管；缝合；T管夹闭中图分类号：R657.42文献标式码：BTheeffecto
3、fdifferentcommonbileductsuturemethodsonbiliaryleakcausedbyclosingT-tubeinstantlyfollowinglaparoscopiccommonbileduct122322WANGMeng-qin,SHIYu-bao,LUBei,LIWei-jun,DONGWan-bin,WANGXin-bo(1.HebeiNorthUnviersity,ZhangJiakou,Hebei075000,P.R.China;2.DepartmentofGeneralSurgery,theSecondAffiliatedHos
4、petialofHebeiNorthUnviersity,Xuanhua,Hebei075100,P.R.China;3.YangyuanPeople'sHospital,Yangyuan,Hebei075800,P.R.China)Abstract:【Objective】ToevaluatethefeasibilityofclosingT-tubeinstantlyfollowinglaparoscopiccommonbileductexploration，andexploretherelationshipbetweenpostoperativebiliaryleakand
5、intraoperativeclosingT-tubeinstantly.【Methods】152patientswereclosedT-tubeinstantlyfollowinglaparoscopiccommonbileductex－plorationandrandomlydividedintothreegroupsbydifferentcommonbileductsuturemethodswithvarioussuturematerials.Theincidenceofintraoperativeandpostoperativebiliaryleakwereobser
6、vedineachgroup,andcommonbileductpressurewasrecordedrespectivelyatthesametime.【Results】Therewere13cases(26.00%)ofbileleak－ageoccurredin3-0absorbablethreadinterruptedsuturegroup,9cases(16.98％)in3-0absorbablelinecontinuoussuturegroup,and0casein3-0vlocklinecontinuoussuturegrouprespectively,comp
7、arisonofbiliaryleakratea－mongthreegroupswerewithsignificantstatisticalsignificance(P<0.05).Allpatientsofbileleakagewererestorationaftersimpleabdominalcavitydrainageandhadnoextrahepaticbileductstrictureafteroperationorotherseriouscomplications,nodeathoccu
