胆道探查术中自制自脱落支架内引流及一期缝合的临床应用  

Clinical application of self-made stent drainage and primary suture in bile duct exploration

作　　者：付金强[1] 乌建平[1] 王清[1] 薛谦 FU Jinqiang;WU Jianping;WANG Qing;XUE Qian(Department of Hepatobiliary Surgery of Leshan People’s Hospital,Leshan 614000,Sichuan Province,China)

机构地区：[1]乐山市人民医院肝胆外科,四川乐山614000

出　　处：《西南医科大学学报》2020年第3期276-279,共4页Journal of Southwest Medical University

摘　　要：目的:探讨胆道探查术中自制自脱落支架内引流及一期缝合的应用价值。方法:选择我院2016年6月至2019年4月行手术治疗胆总管结石患者198例作为研究对象,根据手术方式随机分为A、B两组,A组97例行胆总管自制自脱落支架内引流+一期缝合,B组101例行胆总管置入T管引流。观察并比较两组患者一般情况、手术时间、术后并发症等情况。结果:A、B两组患者一般情况、手术时间、术中出血量差异均无统计学意义(P> 0.05),但术后A组排气时间、住院时间及费用均低于B组,差异有统计学意义(P <0.05)。A组术后并发症的发生率较B组明显降低,差异有统计学意义(P <0.05)。结论:胆总管探查取石术中自制自脱落支架内引流、一期缝合比传统T管引流更具优势,值得在基层医院进一步推广应用。Objective:To investigate the application value of drainage with a self-made self-releasing stent and primary suture in bile duct exploration.Methods:A total of 198 patients who underwent surgical treatment of common bile duct stones in our hospital from June 2016 to April 2019 were enrolled,and according to the surgical procedure,they were divided into groups A and B.The 97 patients in group A underwent drainage with a self-made self-releasing stent and primary suture,and 101 patients in group B underwent T-tube drainage of the common bile duct.The two groups were compared in terms of general status,time of operation,and postoperative complications.Results:There were no significant differences between groups A and B in general status,time of operation,and in⁃traoperative blood loss(P>0.05),but after surgery,group A had a significantly shorter time to first flatus,a signif⁃icantly shorter length of hospital stay,and significantly lower costs than group B(P<0.05).Group A had a signifi⁃cantly lower incidence rate of postoperative complications than group B.Conclusion:Drainage with a self-made self-releasing stent and primary suture have advantages over conventional T-tube drainage in common bile duct ex⁃ploration and cholecystolithotomy and thus hold promise for clinical application in primary hospitals.

关 键 词：胆总管结石 支架引流 一期缝合 T管引流 

分 类 号：R657.4[医药卫生—外科学]