腹腔镜胆道探查术后胆管一期缝合与T管引流的疗效对比  

Efficacy of primary biliary suture versus T tube drainage after laparoscopic biliary exploration

作　　者：李亮亮 LI Liangliang(Department of General Surgery, Fourth People′s Hospital of Rugao, Rugao, Jiangsu, 226500)

机构地区：[1]江苏省如皋市第四人民医院普通外科,江苏如皋226500

出　　处：《实用临床医药杂志》2018年第23期33-35,39,共4页Journal of Clinical Medicine in Practice

摘　　要：目的对比腹腔镜胆道探查术后胆管一期缝合与T管引流的疗效。方法抽取100例胆囊结石并发胆总管结石患者为研究对象,将腹腔镜胆道探查术后胆管一期缝合的患者设为一期缝合组,将腹腔镜胆道探查术后T管引流的患者设为T管引流组,比较2组患者的治疗总有效率、住院期间各项指标、总并发症发生率。结果一期缝合组患者治疗总有效率为100%,显著高于T管引流组的88. 00%(P <0. 05);一期缝合组患者手术时间、术中出血量、住院时间、胃肠功能恢复时间、引流管留置时间、胆汁引流量等指标均优于T管引流组(P <0. 05);一期缝合组患者总并发症发生率为8. 00%,显著低于T管引流组患者总并发症发生率24. 00%(P <0. 05)。结论对于胆囊结石并发胆总管结石患者,腔镜胆道探查术后胆管一期缝合是相对理想的治疗方式,不仅可缩短其住院时间与康复时间,还可提升患者治疗总有效率与生活质量,安全性极高。Objective To compare the effect of primary suture versus T tube drainage after laparoscopic biliary exploration.Methods A total of100cases with cholecystolithiasis complicated with choledocholithiasis were selected,and were divided into two groups according to different treatments.Patients who underwent primary biliary suture after laparoscopic biliary exploration were in the primary suture group and those who underwent T-tube drainage after laparoscopic biliary exploration were in the T-tube drainage group.The total effective rate,the indicators during hospitalization,and the incidence of complications were compared between the two groups.Results The total effective rate of primary suture group was significantly higher than that of T tube drainage group(100.00%vs.88.00%,P<0.05).The operation time,amoun of intraoperative bleeding,hospitalization time,gastrointestinal function recovery time,indwelling time of drainage tube and bile drainage volume of T-tube drainage group were slightly worse than that of one-stage suture group(P<0.05).The total complication rate was8.00%in the primary suture group,which was lower than24.00%in the T tube drainage group(P<0.05).Conclusion One-stage suture of bile duct after laparoscopic choledocholithotomy is a relatively ideal treatment for choledocholithiasis complicated with choledocholithiasis.It can not only shorten the hospitalization time and recovery time,but also enhance the total effective rate,and the quality of life.

关 键 词：胆囊结石 胆总管结石 腹腔镜胆道探查 胆管一期缝合 T管引流 

分 类 号：R575.6[医药卫生—消化系统]