肝胆胰外科杂志2026，Vol.38Issue(1)：44-48,5.DOI:10.11952/j.issn.1007-1954.2026.01.009
腹腔镜胆总管探查术在有上腹部手术史胆总管结石患者中的临床应用
Clinical application of laparoscopic common bile duct exploration in patients with choledocholithiasis who have a history of upper abdominal surgery
摘要
Abstract
Objective To evaluation of the safety and feasibility of laparoscopic common bile duct exploration(LCBDE)in patients with choledocholithiasis who have a history of upper abdominal surgery.Methods A retrospective cohort study was conducted,including 96 patients with choledocholithiasis who underwent LCBDE in the First Affiliated Hospital of Wannan Medical College between January 2021 and December 2022.Patients were divided into two groups based on the history of upper abdominal surgery:the observation group(with a history of upper abdominal surgery,n=36)and the control group(without such a history,n=60).By comparing the two groups in terms of methods for establishing pneumoperitoneum,techniques for common bile duct closure,operation time,intraoperative blood loss,conversion rate,stone clearance rate,hospitalization time,postoperative complications and their management strategies,and postoperative laboratory indicators,a comprehensive evaluation of surgical efficacy and safety was conducted.Results Compared with the control group,the proportion of pneumoperitoneum established using the Hasson technique was significantly higher[38.9%(14/36)vs 1.7%(1/60)],the operation time was longer[150.0(120.0,180.0)min vs 120.0(100.0,145.0)min,P=0.022]in the observation group.However,there was no statistically significant differences in the rate of primary common bile duct closure[(2.8%(1/26)vs 8.3%(5/60)),intraoperative blood loss[15.0(10.0,15.0)mL vs 15.0(10.0,15.0)mL],hospitalization time[10.0(8.0,12.5)d vs 11.0(9.0,12.0)d],conversion rate(8.3%vs 0),stone clearance rate(100.0%vs 96.7%),total postoperative complication rate(16.7%vs 5.0%),or blood test indicators WBC count on the first day after surgery[13.8(7.4,16.3)×109/L vs 11.1(8.5,15.2)×109/L],ALT[70.5(47.0,105.5)U/L vs 56.5(39.5,96.5)U/L],AST[(56.3±38.3)U/L vs(53.6±31.7)U/L],GGT[272.5(126.5,339.3)U/L vs 196.0(86.5,386.0)U/L]between the observation group and control group(all P>0.05).Conclusion For patients with choledocholithiasis who have a history of upper abdominal surgery,LCBDE demonstrates high safety and feasibility in clinical applications,making it worthy of further promotion.关键词
胆总管结石/腹腔镜胆总管探查术/上腹部手术史Key words
choledocholithiasis/laparoscopic common bile duct exploration/history of upper abdominal surgery分类
医药卫生引用本文复制引用
冯之文,张文君,陈晓鹏..腹腔镜胆总管探查术在有上腹部手术史胆总管结石患者中的临床应用[J].肝胆胰外科杂志,2026,38(1):44-48,5.基金项目
安徽省卫健委重点科研项目(AHWJ2022a016) （AHWJ2022a016）
皖南医学院校级重点项目科研基金(WK2022ZF21). （WK2022ZF21）
