胆总管探查切口一期缝合与支架置入后一期缝合动物实验对比研究  

Animal experiment on primary choledochorrhaphy and choledochorrhaphy over a biliary stent in common bile duct exploration

作　　者：田明国[1] 田明祥[2] 张培建[2] 张杰[2] 刘歆农[2] 王立云[1] 将永军[2] 罗小江[2] 张佳风[2] 

机构地区：[1]宁夏回族自治区人民医院肝胆外科,宁夏回族自治区750001 [2]扬州大学第二临床医学院普通外科研究室,江苏扬州225000

出　　处：《实用临床医药杂志》2013年第19期1-3,6,共4页Journal of Clinical Medicine in Practice

基　　金：宁夏回族自治区科技攻关计划项目(2011ZYS261);江苏省扬州市科技攻关项目(YZ2009051)

摘　　要：目的比较胆总管探查切口一期缝合与支架置入后一期缝合的动物实验效果。方法选择小型家猪16只,胆总管探查后分别行胆管切口一期缝合和置入自行脱落胆道支架后切口一期缝合。术后观察胆漏发生率、胆管切口处狭窄程度及组织病理学变化。结果单纯一期缝合组胆漏率、胆管狭窄程度明显高于支架引流后一期缝合组,单纯一期缝合易发生腹腔粘连,胆管切口处炎细胞浸润及纤维化更加明显。结论在胆总管探查术中置入胆道支架再行切口一期缝合可有效降低术后胆漏及胆管狭窄率。Objective To compare the operative effect of two styles of primary choledochor- rhaphy in common bile duct exploration. Methods Sixteen young pigs were selected for common bile duct exploration followed by primary choledochorrhaphy and choledochorrhaphy over self-releasing bili- ary stent. The incidence of bile leakage, degree of bie duct stricture and local pathological changes were observed. Results Incidence of bile leakage and degree of bile duct stricture in simple primary choledochorrhaphy is significantly higher than that of choledochorrhaphy over self-releasing biliary stent. In simple primary choledochorrhaphy, peritoneal adhesion, inflammatory cell infiltration and fi- brosis at the site of the choledochostomy were more prominent. Conclusion Placement of a biliary stent before choledochorrhaphy during common bile duct exploration can reduce incidence of bile leak- age and biliary stricture.

关 键 词：一期缝合 自行脱落胆道支架 胆总管探查术 动物实验 

分 类 号：R575[医药卫生—消化系统]