关键词: 腹腔镜胆总管探查, 单向倒刺线, 普通可吸收线, 连续缝合

Abstract:

Abstract objective To investigate the safety and efficacy of unidirectional barbed suture in primary continuous closure of laparoscopic common bile duct exploration. Methods A total of 81 patients with choledocholithiasis underwent laparoscopic common bile duct exploration from Jun. 2016 to Dec. 2017 were prospectively analyzed. According to the random number table method, patients were randomly divided into unidirectional barbed suture group (n=41) and normal absorbable suture group (n=40). The time of common bile duct suture closure,
postoperative complications, postoperative hospitalization duration and follow-up were recorded and compared. Results All the patients were successfully operated, and the stones were removed during operation. There was no intraoperative complications. Time of common bile duct suture closure in unidirectional barbed suture group was less than that in normal absorbable suture group [(11.4±2.0) min vs (15.6±3.5) min, t=-6.67, P<0.05]. The incidence of bile leakage (2.4% vs 5.0%), acute cholangitis (4.9% vs 5.0%), and the average postoperative
hospitalization duration [(4.4±1.2) d vs (4.4±1.6) d] between the two groups were not statistically significant (P>0.05). All patients were followed up. Eighteen cases in unidirectional barbed suture group and 15 cases in normal absorbable suture group were followed up for more than half a year. No residual stones, recurrence of stones or bile duct stricture was found after operation. Conclusion Laparoscopic common bile duct exploration with continuous unidirectional barbed closure is safe and feasible, which can reduce laparoscopic suture difficulty, shorten the suture time, and does not increase the incidence risk of complications.

Key words: laparoscopic common bile duct exploration,  unidirectional barbed line, normal absorbable line, continuous suture