目的 探讨西藏高原腹腔镜下胆总管切开探查一期缝合的可行性。方法 回顾性分析2015-02至2018-06武警西藏总队医院收治的48例腹腔镜下胆总管切开探查患者的病例资料,根据胆总管切开后的处理方式,分为一期缝合组及T管引流组,比较两组临床效果。结果 一期缝合组患者手术时间、术后住院时间均短于T管引流组(P<0.05),两组术中出血量、术后胆计漏发生率、拨出腹腔引流管时间、术后腹腔内少量胆囊窝积液发生率比较,差异均无统计学意义。结论 在严格掌握手术适应证的前提下,西藏高原腹腔镜下胆总管切开一期缝合是安全可行的。

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.