胆总管探查术中胆道镜注水加压法对末端胆管结石残留及复发的影响  

Effect of Intraoperative Water Flooding Compression for Choledochoscope during Common Bile Duct Exploration on Residual and Recurrence of Terminal Bile Duct Stones

作　　者：谢亮[1] 张光全[1] 姚波[1] XIE Liang;ZHANG Guang-quan;YAO Bo(Department of Hepatobiliary and Gastrointestinal Surgery, the Sixth People's Hospital of Chengdu, Chengdu 610051, China)

机构地区：[1]成都市第六人民医院肝胆胃肠外科,成都610051

出　　处：《解放军医药杂志》2019年第5期78-81,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省医学科研青年创新课题(Q17010)

摘　　要：目的分析胆总管探查术中胆道镜注水加压法对末端胆管结石残留及复发的影响。方法选取2016年1月—2018年1月在我院行胆总管探查术的患者625例,按术中是否进行胆道镜注水加压分为观察组和对照组,每组325例。对照组采用腹腔镜常规探查,观察组采用腹腔镜治疗加压探查。比较2组一般手术情况、应激反应指标、并发症发生率及术后1年结石复发率。结果 2组手术时间、切口长度、术中出血量、肠鸣音恢复时间、腹腔引流时间、肛门排气时间、住院时长、治疗后应激反应指标和并发症发生率比较差异均无统计学意义(P>0.05)。观察组术后1年内结石复发率显著低于对照组(P<0.05)。结论胆总管探查术中胆道镜注水加压法可有效显示末端胆管结石残留,降低术后复发率。Objective To analyze effect of intraoperative water flooding compression for choledochoscope during common bile duct exploration on residual and recurrence of terminal bile duct stones. Methods A total of 625 patients undergoing common bile duct exploration during January 2016 and January 2018 were divided into observation group and control group ( n =325 in each group) according to whether or not having intraoperative water flooding compression for choledochoscope. Control group was treated with laparoscopic routine exploration, while observation group was treated with intraoperative water flooding compression for choledochoscope. Conditions of general surgery, indexes of stress reaction, incidence rates of complications and recurrence rates of stones in 1 year after surgery were compared between two groups. Results There were no significant differences in operative time, incision length, intraoperative bleeding volume, recovery time of bowel sound, drainage time of abdominal cavity, anal exhaust time, length of hospital stay, post-treatment indexes of stress reaction and incidence rate of complication between two groups ( P >0.05). Recurrence rate of stones in 1 year after surgery in observation group was significantly lower than that in control group ( P <0.05). Conclusion Intraoperative water flooding compression for choledochoscope during common bile duct exploration may effectively show residual of bile duct stones and reduce recurrence rate.

关 键 词：胆总管结石 胆总管探查术 胆道镜注水加压法 复发 

分 类 号：R657.4[医药卫生—外科学]