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Clinical feasibility of primary suture in laparoscopic common bill duct exploration on Tibetan plateau |
HU Gende, ZHANG Aipeng, LI Huibin, XU Xiaodong |
Department of Hepatobiliary Surgery,Tibet Autonomous Region Corps Hospital of Chinese People’s Armed Police Force,Lhasa 850004,China |
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Abstract Objective To study the clinical feasibility of primary suture in laparoscopic common bill duct exploration on the Tibetan plateau.Methods This is a retrospective analysis of patients who underwent primary closure of the CBD after laparoscopic choledochotomy between February 2015 and June 2018 in Tibet Autonomous Region Corps Hospital of Chinese People’s Armed Police Force. 48 cases were divided into control group and observation group according to the operative method. 25 cases in primary closure group as observation group and 23 cases in intraoperative indwelling T-tube drainage group as control group. Clinical effect was compared between the two groups.Results The duration of surgery and the postoperative hospital stay were shorter in the observation group than in the control group, and the difference was statistically significant(P<0.05). However, there was no statistically significant difference between the two groups in intraoperative blood loss, the incidence of bile leakage, duration of abdominal drainage or in the amount of ascites.Conclusions Primary suture used in laparoscopic common bill duct exploration is safe and feasible when an appropriate surgical approach is chosen on the Tibetan plateau.
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Received: 30 January 2019
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[1] |
刘俊杰,赵 俊.现代麻醉学[M].2版.北京:人民卫生出版社,1997:956-957.
|
[2] |
杨 波,侯永志,王翔飞,等. 西藏高原地区胆囊结石危险因素分析[J].临床肝胆病杂志,2018,34 (4):789-794.
|
[3] |
董桂银,喻宗繁,陈江明.双镜联合胆总管切开一期缝合治疗胆总管结石的临床体会[J].肝胆外科杂志,2017,25(4):262-264.
|
[4] |
黄建端,傅玉江,澎淑果,等.高原实用外科学[M].拉萨:西藏人民出版社,1991:11-12.
|
[5] |
陈国平,仁 桑,巴桑顿珠,等.高原腹腔镜胆囊切除术不同CO2气腹压对呼吸及术后不良影响[J].西藏科技,2017, 297(12):50-52.
|
[6] |
潘成文,吴育连.腹腔镜与开腹胆总管取石一期缝合的临床比较[J].中国微创外科杂志,2016,16(6):518-521.
|
[7] |
Podda M,Polignano F M,Lhmann A,et al.Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic commou bile duct exploration for choledocholithiasis[J].Surg Endosc,2016, 30(3):845-861.
|
[8] |
张红卫,罗 旋,曹 君,等.腹腔镜胆总管探查取石术后一期缝合不放置引流管的安全性[J].中华消化外科杂志,2014,9(13):691-693.
|
[9] |
张爱民,熊良昆,余 佳. 腹腔镜手术一期缝合胆总管治疗胆总管结石的研究进展[J].临床外科杂志,2015,23(12):949-951.
|
[10] |
姚国忠,晏 江,吴 醒,等.胆总管结石患者腹腔镜胆总管切开探查并一期缝合的临床体会[J].实用临床医药杂志,2018,22(17):116-118.
|
[11] |
上官昌盛,丁佑铭.腹腔镜胆总管探查一期缝合与T管引流在治疗胆总管结石中的临床应用[J].腹部外科,2015,28(4):258-261.
|
[12] |
彭 靖,马军亮,朱智辉,等. 腹腔镜胆总管切开取石一期缝合术的体会[J].腹部外科,2016,29(5):353-359.
|
[13] |
Alhamdani A,Mahmud S,Jameel M,et al.Primary closure of choledochotomy after emergency laparoscopic common bile duct exploration[J].Surg Endose,2008,22(10):2190-2195.
|
[1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(8): 709-710. |
|
|
|
|