胆囊管远端丝线结扎在不同直径胆囊结石中的应用价值OA
The application value of suture ligation at the distal cystic duct for cholecystolithiasis of different diameters
目的:探讨胆囊管远端丝线结扎治疗不同直径胆囊结石的应用价值.方法:将 2025 年 1～6 月行腹腔镜胆囊切除术(LC)的 161 例胆囊结石患者根据结石大小分为 A 组(结石直径<2 cm,n=101)与 B 组(结石直径>2 cm,n=60);再根据术中离断胆囊管前是否使用丝线结扎胆囊管远端分为丝线组与钛夹组,A 组中丝线组 51 例,钛夹组 50 例,B 组中丝线组 30例,钛夹组 30 例.分别比较术中情况、预后及术后住院时间.结果:A 组中丝线组与钛夹组胆囊切除时间、标本取出时间、标本袋破裂、术中出血、术后住院时间、并发症差异均无统计学意义(P>0.05),丝线组胆囊破裂少于钛夹组,差异有统计学意义(P<0.05);B 组中丝线组与钛夹组胆囊切除时间、标本袋破裂、术中出血、术后住院时间、中转开腹、并发症差异均无统计学意义(P>0.05),丝线组标本取出时间短于钛夹组,胆囊破裂少于钛夹组,差异有统计学意义(P<0.05).结论:胆囊管远端丝线结扎可安全地应用于 LC 术中,可有效减少胆囊破裂,对于结石直径>2cm 的患者能显著缩短胆囊取出时间,且不延长手术时间、增加并发症,值得临床推广.
Objective:To investigate the application value of distal cystic duct ligation with silk suture for cholecystolithiasis of different diameters during laparoscopic cholecystectomy(LC).Methods:A total of 161 patients with cholecystolithiasis who underwent LC for from Jan.2025 to Jun.2025 were divided into Group A(stone diameter<2 cm,n=101)and Group B(stone diameter>2 cm,n=60).Each group was further divided into the suture group and the titanium clip group according to whether the distal cystic duct was ligated with silk suture before cystic duct transection.In Group A,there were 51 cases in the suture group and 50 cases in the titanium clip group;in Group B,there were 30 cases in the suture group and 30 cases in the titanium clip group.The two groups were compared in terms of intraoperative conditions,prognosis,and postoperative hospital stay.Results:In Group A,there were no significant differences between the suture group and the titanium clip group in cholecystectomy time,specimen retrieval time,specimen bag rupture,intraopera-tive bleeding,postoperative hospital stay,and complications(P>0.05),while the incidence of gallbladder rupture in the suture group was lower than that in the titanium clip group,and the difference was statistically significant(P<0.05).In Group B,no significant diffe-rences were found between the suture group and the titanium clip group in cholecystectomy time,specimen bag rupture,intraoperative bleeding,postoperative hospital stay,conversion to open surgery and complications(P>0.05).The specimen retrieval time of the suture group was shorter than that of the titanium clip group,and the incidence of gallbladder rupture was lower,with statistically significant differences(P<0.05).Conclusions:Distal cystic duct ligation with silk suture can be safely used in LC,which can effectively reduce gallbladder rupture.For patients with stone diameter>2 cm,it can significantly shorten the specimen retrieval time without prolonging the operation time or increasing complications,which is worthy of clinical promotion.
李冬永;赵磊;曹映涛;李建光;吴肖汶;杨涛;杞映华
保山市人民医院普通外科,云南 保山,678000保山市人民医院普通外科,云南 保山,678000保山市人民医院普通外科,云南 保山,678000保山市人民医院普通外科,云南 保山,678000保山市人民医院普通外科,云南 保山,678000保山市人民医院普通外科,云南 保山,678000保山市人民医院普通外科,云南 保山,678000
医药卫生
胆囊结石病胆囊切除术,腹腔镜胆囊管丝线结扎钛夹
CholecystolithiasisCholecystectomy,laparoscopicCystic ductSuture ligationTitanium clip
《腹腔镜外科杂志》 2026 (5)
347-352,6
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