The Application Research Of Unidirectional Barbed Suture In Laparoscopic Common Bile Duct Exploration And Primary Suture

Background and Objective:In recent years, with the development of minimally invasive techniques,Laparoscopic common bile duct exploration and primary suture(LBEPS) has become a commonly used method for the treatment of common bile duct stones.But it has been greatly limited by the operation of laparoscopic high technical requirements.unidirectional barbed suture is a new type of knotless absorbable suture,which can avoided kont component in the operation and promote the laparoscopic suturing.The efficacy of barbed sutures have been reported in gynecologic and urologic surgery to date.But there are few reports in general surgery.So through a comparative study of unidirectional barbed suture and ordinary absorbable suture,to evaluate the feasibility,safety and application effect of unidirectional barbed suture in laparoscopic common bile duct exploration and primary suture.Methods:From January 2013 to December 2014, all 55 patients undergoing LBEPS were enrolled in the retrospective study,and divided into two groups according to the different suture type which be used intraoperative: A group, the unidirectional barbed suture group(23 cases); B group, ordinary absorbable suture group(32 cases).Compare two groups of intraoperative situation:(operation time, intraoperative blood loss) and postoperative situation( postoperative intestinal function recovery time, the incidence of bile leakage,postoperative hospital stay and related complications).The preoperative general information and postoperative complications were analysized by the Chi-square test.The operative time,blood loss,postoperative hospital stay and intestinal function recovery time were analysized by two-sample t-test analysis.The data was calculated by SPSS 22.0 statistical software, with α = 0.05 level for the test level.Results:1. General situation: There were no significant difference between the two groups in age distribution, sex ratio, diameter of common bile duct, common bile ductstone diameter, number of common bile duct stone, and total bilirubin level.2. Intraoperative situation:In the operation time,Two groups of patients have statistically significant difference between two groups.The operation time of group A was significant less than group B.Intraoperative blood loss was no statistically significant difference between the two groups.(P>0.05)3. Postoperative situation:In postoperative intestinal function recovery time,incidence of bile leakage, postoperative hospital stay and related complications, there was no statistically significant difference between two groups.(P>0.05)。Conclusion:1. The unidiretional barbed suture was safe and feasible, which can easy to operate in laparoscopic common bile duct exploration and primary suture.2. When laparoscopic common bile duct exploration and primary suture was performed,unidirectional barbed suture would be shorted the operation time compare with ordinary absorbable suture, but not increased incidence of bile leakage and other complications.