单向倒刺线与普通可吸收线在腹腔镜下胆总管切开取石一期缝合术中应用的对比研究

摘要： 目的 评价单向倒刺线（可吸收缝合线v-locTM180）在腹腔镜下胆总管切开取石一期缝合术中应用的安全性及效果。方法 回顾性分析2014年7月-2015年6月该科由同一术者主刀完成的腹腔镜下胆总管切开取石一期缝合术86例，分为倒刺线连续全层缝合胆总管组（A组）、普通可吸收线连续全层缝合胆总管组（B组）、普通可吸收线间断全层缝合胆总管组（C组）。比较各组患者胆总管缝合所需时间、术中出血量、术后进食时间、术后住院天数和术后胆瘘发生的差异。结果 86例均顺利完成腹腔镜下胆总管切开取石一期缝合手术，术中不需放置T管，无中转开腹病例。A组胆总管缝合所需时间与B、C组相比均有统计学意义（P <0.05）；各组两组比较在术中出血量、术后进食时间和术后住院天数方面差异无统计学意义；A组术后未出现胆瘘，B组术后胆瘘1例，C组术后胆瘘2例。结论 在腹腔镜胆总管切开取石一期缝合术中，单向倒刺线连续全层缝合胆总管是操作简单、安全可行的。
Abstract: Objective To evaluate the safety and effect of one-way barbs line (absorbable sutures v - locTM180) in primary suturing of laparoscopic choledocholithotomy. Methods From July 2014 to June 2015, clinical data of 86 cases performed primary suturing in laparoscopic choledocholithotomy by the same performer were retrospectively analyzed. The patients were divided into three groups, One-way barbs line continuous full-thickness suture group (A group), ordinary absorption line continuous full-thickness suture group (B group) and ordinary absorption line discontinuous full-thickness suture group (C group). The bile duct suture needed time, intraoperative blood loss, postoperative eating time, postoperative hospital stay and postoperative bile fistula were compared. Results All the 86 cases underwent successful operation without T tube, and none of them received alternative open operation. Compared with group B and C, time needed for bile duct suturing in A group have statistical significance. There was no significant difference in the intraoperative blood loss, postoperative eating time, postoperative hospital stay between the three groups (P > 0.05). The incidence of postoperative bile fistula in A group were none. The incidence of postoperative bile fistula in B group was 1 case, the incidence of postoperative bile fistula in C group was 2 cases. Conclusions The method of one-way barbs line continuous full-thickness suture were simple and secure in primary suturing of laparoscopic choledocholithotomy.