三镜联合胆总管探查一期缝合术中置鼻胆管的应用体会  

Application of ENBD during triple endoscopies combined with exploration and primary suture of common bile duct

作　　者：高志强[1] 俞亚红[1] 申铭[1] 薛新波[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胆胰外科,武汉市430030

出　　处：《实用医学杂志》2013年第20期3376-3379,共4页The Journal of Practical Medicine

基　　金：武汉市科技攻关项目(编号:201260523171-3)

摘　　要：目的:探讨三镜联合胆总管探查一期缝合术中置鼻胆管的可行性及临床应用价值。方法:随机将145例胆总管结石患者分为一期缝合鼻胆管引流组(94例)和T管引流组(51例),对比两组患者的手术时间、术中出血量、术后住院时间、术后肠道功能恢复时间、拔管时间、胆汁引流时间及并发症发生情况。结果:两组患者在手术时间、术中出血量、拔管时间及并发症发生率方面无明显统计学差异(P>0.05)。而在术后住院时间、术后肠道功能恢复时间、胆汁引流时间等方面,差异有统计学意义(P<0.05)。结论:在严格掌握手术适应证的基础上,三镜联合胆总管探查一期缝合术中置鼻胆管是安全可行的。Objective To explore the feasibility and clinical value of ENBD placement during triple endoscopies combined with exploration and primary suture of common bile duct. Methods 145 patients with choledocholithiasis were randomly divided into primary suture with ENBD drainage group （94 patients） and T-tube drainage group （51 patients）. Surgical duration, intraoperative blood loss, postoperative length of hospital stay, time to restoration of postoperative intestinal function, time to removal of abdominal cavity drainage tube, time to bile drainage, and complications were compared between the two groups. Results There were no significant differences in surgical duration, intraoperative blood loss, time to removal of abdominal cavity drainage tube and postoperative complications between the two groups （P 〉 0.05）. Postoperative length of hospital stay, time to restoration of bowel function, and time to bile drainage differed significantly （P 〈 0.05）. Conclusions On the basis of strict control of surgical indications, application of ENBD during triple endoscopies combined with exploration and primary suture of common bile duct is safe and feasible.

关 键 词：鼻胆管 胆总管探查 腹腔镜 一期缝合 

分 类 号：R657.4[医药卫生—外科学]