细导管胆道引流在胆总管一期缝合术中的应用  

Application of bile duct drainage with small catheter in primary suture of common bile duct wound

作　　者：赵国栋[1] 丁明金[1] 张俊华[1] 

机构地区：[1]南通大学医学院附属丹阳医院肝胆外科,江苏省丹阳市212300

出　　处：《中华肝胆外科杂志》2006年第8期524-526,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的评价经胆囊管残端细导管胆道引流在胆总管探查、胆管一期缝合术中的应用价值。方法回顾分析经胆囊管残端细导管胆道引流应用于开腹胆总管探查、胆管一期缝合术256例病例的临床资料。结果全组256例均手术成功,术后无胆漏、胆管狭窄等并发症。术后5～7 d 拔管253例,术后10 d 拔管3例,无拔管并发症发生。术中结石取净率为99.6%(255/256)。术后住院时间为(6.7±3)d。随访256例,时间1～5年,平均3年,B 超检查无胆管狭窄。结论经胆囊管残端细导管胆道引流在开腹胆总管探查胆道一期缝合术中的应用,对预防术后胆漏、胆总管狭窄以及对术后遗留病变的诊断和治疗有广泛的应用价值。该方法安全、可靠、有效。Objective To determine the value of bile duct （BD） drainage with small catheter via stump of the cyst duct in primary suture of the BD wound after common BD exploration. Methods The clinical data of 256 patients receiving the drainage in our hospital were retrospectively analyzed. Results The operation was successfully performed in all the 256 patients. There were no complications such as bile leakage and bile duct stricture etc. The small catheter was withdrawn in 5-7 d in 253 patients and 10 d in 3 after the operation. There was no discomfort after removing the catheter. The stone-cleaning rate was 99.6% （255/256）. The mean duration of hospitalization after the operation was 6.7!3 d. The average follow-up time in all the 256 patients was 3 years. No bile duct stricture was found by B-mode ultrasonography during the follow-up period. Conclusions This method is safe, feasible and effective and has extensive clinical value for diagnosis, treatment and prevention of postoperative bile leakage, bile duct stricture and remnant diseases.

关 键 词：胆道外科手术 胆总管 一期缝合 胆道引流 细导管 

分 类 号：R657.4[医药卫生—外科学]