腹腔镜外科杂志2024，Vol.29Issue(5)：353-357,362,6.DOI:10.13499/j.cnki.fqjwkzz.2024.05.353
腹腔镜下应用倒刺线行胆肠吻合的临床分析
Clinical analysis of laparoscopic choledochojejunostomy with barbed suture
摘要
Abstract
Objective:To investigate the feasibility and safety of laparoscopic application of barbed wire for biliary-enteric anas-tomosis.Methods:Retrospective analysis was made on clinical data of 38 patients who underwent laparoscopic biliary-intestinal anasto-mosis from Jan.2021 to Jul.2023.Patients were divided into the barbed wire group(n=18)and the control group(n=20)based on the type of suture material used.In the barbed wire group,barbed wire was used in laparoscopic biliary-intestinal anastomosis,including 18 cases of benign lesions(9 cases of typeⅠor typeⅣb choledochal cysts,2 cases of distal common bile duct stricture,and 1 case of anastomotic stricture reconstruction)and 6 cases of malignant lesions(3 cases of pancreatic head cancer and 3 cases of periampullary cancer).In the control group,the laparoscopic biliary-intestinal anastomosis was performed with absorbable surgical sutures,including 13 cases with benign lesions(all typeⅠor typeⅣb choledochal cysts)and 7 cases with malignant lesions(3 cases of pancreatic head cancer and 4 cases of periampullary cancer).Perioperative clinical indexes of the two groups were comparatively analyzed.Results:The biliary-intestinal anastomosis time was shorter in the barbed wire group than that in the control group,with statistically significant diffe-rence[(16.90±1.33)min vs.(23.06±2.44)min,P＜0.05].There was no statistically significant difference in the intrahepatic bile duct diameter[(18.83±2.92)mm vs.(19.80±1.91)mm]and anastomotic stoma inner diameter[(17.33±2.47)mm vs.(18.00±1.75)mm]between the two groups(P＞0.05).There were no statistically significant differences between the two groups in the post-operative removal time of drainage tubes at biliary-intestinal anastomotic stoma,anastomotic leakage,liver function and infection indica-tors on postoperative 1st,3rd,and 7th day(P＞0.05).Both groups did not experience any strictures.All patients recovered smoothly and were safely discharged.Follow-up CT scans at 1-3 months after operation showed no bile duct dilatation,new hydrops abdominis,the short-term prognosis was satisfying without abdominal pain,fever or other symptoms.Conclusions:The application of barbed wire in laparoscopic biliary-intestinal anastomosis is safe and feasible,and can shorten the suture time of biliary-enteric anastomosis.关键词
腹腔镜检查/胆肠吻合/倒刺线Key words
Laparoscopy/Biliary-enteric anastomosis/Barbed wire分类
医药卫生引用本文复制引用
罗琦弋,谭喜娟,陆礼柏,罗宗将,马嘉盛,赵振荣,汪建初..腹腔镜下应用倒刺线行胆肠吻合的临床分析[J].腹腔镜外科杂志,2024,29(5):353-357,362,6.基金项目
国家自然科学基金(82060441) （82060441）
广西临床重点专科建设项目(桂卫医发(2022)17号) （桂卫医发(2022）
广西高等教育本科教育改革工程项目重点项目(2021JGZ147) （2021JGZ147）
