大网膜包绕预防T管拔出后胆漏的临床研究  

Study the effect of using pedicled greater omentum wraping up bile drainage tract to prevent bile leakage after removal of T-tube

作　　者：杨志奇[1] 孙振纲[1] 黄军[1] 胡涛[1] 王锐[1] 肖元初[1] 聂传庚[1] 王万垠[1] 胡继明[1] 朱振新[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院肝胆外科,湖北荆州434020

出　　处：《腹部外科》2009年第3期169-170,共2页Journal of Abdominal Surgery

基　　金：湖北省卫生厅科研基金(JX2B87)

摘　　要：目的探讨采用带蒂大网膜在T管引流管周围做成人工窦道的方法以及临床效果。方法2005年12月至2008年12月60例病人行胆管探查,T管引流术,T管置入胆管并作常规性固定后,将T管用带蒂的大网膜包裹,做成人工窦道,其窦道长度与T管在腹腔内的部分相适宜,窦道内径约为2.0～3.0cm,然后将窦道两端分别固定在肝十二指肠韧带和T管出口处的腹膜上。手术后2～3周拔出T管,观察胆漏的情况。结果60例在术后2～3周拔出T管,无胆漏发生。结论采用带蒂大网膜在T管引流管周围形成人工窦道的方法简单、实用,不仅可缩短留置T管的时间,而且可有效防止拔T管后胆漏的发生,有较好的临床应用前景。Objective To evaluate method and effect of using man-made greater omentum wra- ping up bile drainage tract to prevent bile leakage after removal of T-tube. Methods The research is carried out on 60 patients from December 2005 to December 2008. The common operation of bile duct exploration,T-tube indewlling and T-tube drainage is carried out on the 60 patients. Wrap up T-tube with pedicled greater omentum to make a man-made tract. The length of the man-made tract is as long as T-tube indwelling in abdominals, and it＇s diameter is about 2. 0-3. 0 cro. Fix the man-made tract both on hepatoduodenal ligament and peritoneal membrane where T-tube way out. Remove T-tube 2-3 weeks after operation, and observe bile leakage. Results There is no bile leakege in 60 patients ob- served. Conclusion The method of using pedicled greater omentum wraping up bile drainage tract to prevent bile leakage is simple and practical. It can shorten the T-tube indwelling time and pevent bile leakage effectively,with good prospect in clinics.

关 键 词：引流术 手术后并发症 胆总管疾病 胆结石 

分 类 号：R657.4[医药卫生—外科学] R782.11[医药卫生—临床医学]