胆道探查术后胆总管一期缝合的临床研究  

Comparative study of the common bile duct after exploration for different treatment of biliary tract

作　　者：周琨[1] 陆霁[1] 马保金[2] 

机构地区：[1]上海市静安区中心医院普外科,上海200040 [2]复旦大学附属华山医院普外科,上海200040

出　　处：《中国医刊》2016年第8期37-40,共4页Chinese Journal of Medicine

摘　　要：目的研究不同处理方式在腹腔镜下胆总管探查术(laparoscopic common bile duct exploration,LCBDE)后的应用效果,以期为临床提供参考。方法分析2010年1月至2015年6月本院诊治的88例LCBDE患者临床资料,根据胆道的不同处理方式进行分组,术后一期缝合为观察组48例,T管引流为对照组40例,比较两组患者手术时间、术后补液量以及住院时间并分析。结果一期缝合组患者的手术时间、术后补液量、术后住院时间明显较T管引流组患者明显降低,差异具有显著性(P<0.05);两组患者在术中出血量、拔管时间、胃肠通气时间、术后并发症发生情况方面差异无显著性(P>0.05)。一期缝合组患者出现胆漏2例,残留结石1例,无结石复发;T管引流组出现胆漏1例,残留结石3例,无结石复发。结论胆总管探查术后行一期缝合较T管引流能取得更好的疗效,且安全性较高,是一种可行的手术方法。Objective To study the effect of different treatment in the application of the common bile duct after exploration, in order to provide a reference for clinical use. Method The clinical data of 88 cases of laparoscopic common bile duct exploration in our hospital from January 2010 to June 2015 were analyzed, depending on the treatment of biliary grouping, which after a suture that is, the observation group 48 cases, T tube drainage control group 40 cases. Two groups were compared operation time, hospital stay and the amount of fluid analysis. Result The operation time, postoperative fluid infusion volume, postoperative hospital stay of patients in primary suture group were significantly lower than that in T tube drainage group, the difference was significant（P〈0.05）; two groups in blood loss, extubation time, gastrointestinal ventilation, postoperative complications were no significant differences in terms of the case, was not statistically significant（P〉0.05）. A suture patients bile leakage in 2 cases, 1 case of residual stones, no stone recurrence; T tube drainage group bile leakage in 1 case, residual stones in 3 cases, no stone recurrence. Conclusion Compared with T tube drainage, a suture after common bile duct exploration has better effect and higher safety, it is a feasible surgical method.

关 键 词：腹腔镜 胆石症 胆总管缝合 

分 类 号：R657.42[医药卫生—外科学]