Department of Hepatobiliary Surgery, Zigong First People's Hospital, Zigong, China.
J Laparoendosc Adv Surg Tech A. 2021 Nov;31(11):1274-1278. doi: 10.1089/lap.2020.0768. Epub 2020 Dec 21.
The effectiveness and feasibility of the primary closure after laparoscopic common bile duct exploration (LCBDE) have been well demonstrated, however, the incidence of postoperative bile leakage after LCBDE remains high. The current study aimed at investigating whether our new suturing method could reduce the risk of bile leakage after LCBDE. This retrospective study included 81 patients who underwent primary two-layered closure or traditional primary closure of the common bile duct (CBD) after LCBDE, and the related clinical data were compared and analyzed. The primary two-layered closure group had a lower rate of bile leakage compared with the traditional primary closure group ( < .05). There were no significant differences in additional parameters, such as operative time, estimated blood loss, postoperative stay duration, time to drain removal, postoperative pancreatitis, stone recurrence, and overall morbidity. No patients developed bile duct stenosis during the follow-up period. Primary two-layered closure of CBD can reduce the postoperative bile leakage after LCBDE. Moreover, it is a safe and effective therapeutic option for patients with choledocholithiasis.
腹腔镜胆总管探查术（LCBDE）后行一期缝合的有效性和可行性已得到充分证实，然而，LCBDE 后胆漏的发生率仍然较高。本研究旨在探讨我们的新缝合方法是否能降低 LCBDE 后胆漏的风险。本回顾性研究纳入了 81 例行 LCBDE 后行双层一期缝合或传统胆总管（CBD）一期缝合的患者，并对相关临床资料进行了比较分析。双层一期缝合组胆漏发生率低于传统一期缝合组（<0.05）。手术时间、估计出血量、术后住院时间、引流管拔除时间、术后胰腺炎、结石复发和总并发症发生率等其他参数无显著差异。随访期间无患者发生胆管狭窄。胆总管双层一期缝合可降低 LCBDE 后胆漏的发生。此外，对于胆总管结石患者，它是一种安全有效的治疗选择。
