腹腔镜胆总管探查鼻胆管引流与输尿管导管引流的疗效比较  

Clinical efficacy comparison of nasobiliary drainage and ureteral catheter drainage after laparoscopic common bile duct exploration

作　　者：高原[1,2] 陈安平[2] 胡铤[1,2] 李华林 GAO Yuan;CHEN An-ping;HU Ting;et al.(Zunyi Medical College, Zunyi 563003, China;Chengdu Second People Hospital)

机构地区：[1]遵义医学院,贵州遵义563003 [2]成都市第二人民医院

出　　处：《腹腔镜外科杂志》2017年第9期669-672,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜胆总管探查取石术后行鼻胆管引流与输尿管导管引流治疗胆囊结石合并胆总管结石的临床疗效,比较两种方法的优劣。方法:回顾分析2008年11月至2015年10月为124例胆囊结石合并胆总管结石患者分别行腹腔镜胆囊切除术+胆总管探查+鼻胆管引流术(n=61,鼻胆管组)及输尿管导管引流术(n=63,导管组)的临床资料。结果:与鼻胆管组相比,导管组手术时间短、胆道引流管留置时间长,术后第3天胆汁引流量多(P<0.05);两组住院时间、术后第1天与第2天胆汁引流量、术后并发症发生率差异无统计学意义(P>0.05)。结论:腹腔镜胆总管探查取石术后鼻胆管引流及输尿管导管引流治疗胆囊结石合并胆总管结石均安全、有效,扩大了胆总管一期缝合的适应证,避免了传统开腹手术的弊端,并未增加术后胆漏、结石残留、胰腺炎等并发症。Objective：To explore the clinical efficacy of nasobiliary drainage and ureteral catheter drainage after laparoscopic common bile duct exploration in the treatment of cholecystolithiasis combined with choledocholithiasis, and to compare the advantages and disadvantages of the two methods. Methods：Clinical data of 124 patients,who suffered from cholecystolithiasis and choledocholithi- asis, and underwent laparoscopic cholecystectomy, common bile duct exploration, nasobiliary drainage （n = 61, nasobiliary group） or u- reteral catheter drainage （ n = 63, ureteral catheter group） from Nov. 2008 to Oct. 2015, were retrospectively analyzed. Results ： Com- pared with the nasobiliary group, the operation time was shorter, and the retention time of hiliary drainage tube of the ureteral catheter group was longer, the amount of bile drainage of the ureteral catheter group on the third day after surgery was more （ P 〈 0.05 ）. There were no significant differences in the hospitalization time, the bile drainage on the first and second day and the postoperative complica- tions （ P 〉 0.05 ）. Conclusions ： Both nasobiliary drainage and ureteral catheter drainage in laparoscopic common bile duct exploration are safe and effective in the treatment of cholecystolithiasis with choledocholithiasis, expand the indication of primary suture of common bile duct, avoid a series of drawbacks of the traditional open surgery, and do not increase the incidence of postoperative complications, such as bile leakage, residual calculi, pancreatitis and so on.

关 键 词：胆总管结石 胆囊结石病 腹腔镜检查 胆总管探查术 鼻胆管引流 输尿管导管引流 

分 类 号：R657.42[医药卫生—外科学]