腹腔镜胆道探查前瞻性非随机对照研究  

Prospective and nonrandomized study of laparoscopic common bile duct exploration

作　　者：叶永强[1] 王戈[2] 王成交 张帆[2] 张红军[2] 

机构地区：[1]第三军医大学西南医院肝胆外科医院,重庆402100 [2]山东省单县中心医院 [3]山东省郓城县人民医院

出　　处：《腹腔镜外科杂志》2006年第4期292-294,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜胆道手术后不放置T管（胆道）引流的可行性。方法：对2005年2月至2005年11月我院治疗的行腹腔镜胆总管探查的25例患者进行了前瞻性非随机对照研究。分为两组，观察组未放置T管，共15例；对照组放置T管，共10例。结果：患者均恢复良好。随访1～5月，观察组未发现结石复发或其它并发症，对照组1例残余结石，1例胆道下端狭窄，均经保守治疗后痊愈出院。两组结石残留率、近期并发症发生率、住院费用等方面差异无显著性（P〉0．05），而在手术时间、住院时间等方面差异有显著性（P〈0．05）。结论：腹腔镜胆道探查是较成熟的治疗胆总管结石的方法，根据术前影像学检查及术中胆道镜检查结果，决定是否放置T管引流。Objective： To explore the feasibility of T tube free laparocopic common bile duct exploration （LCBDE）. Methods： 25 cases with common bile duct stones received LCBDE between February, 2005 and November, 2005. All patients were divided into T tube group and T tube free group according to results of ultrasound, ERCP, CT or MRCP. Results： LCBDE was performed successfully in all patients. The follow up ranged from 1 to 5 months. There was no complications such as recurrenc stone and bile leakage in T tube free group. Two complications were found in T tube group, one was residual stone and the other was bile duct stricture. There was no significant difference in complication rate and hospital cost in two groups （P 〉 0.05）. But there was significant difference in time of operation and hospitalization （P 〈 0.05）. Conclusions： LCBDE was matured technique in treatment of common bile duct stone. Placing T tube or not in LCBDE can be decided on the results of preoperative images and introperative findings.

关 键 词：胆道探查 胆管结石 腹腔镜手术 

分 类 号：R657.4[医药卫生—外科学]