双镜联合胆总管探查取石胆管可控式自脱支架置入一期缝合与T管引流治疗胆总管结石合并胆管炎疗效分析  

Double Mirrors Combined with Common Bile Duct Exploration and Removal of Stones in the Bile Duct Controllable Self-removing Stent Implantation of Primary Suture and T Tube Drainage for the Treatment of Common Bile Duct Stones with Cholangitis

作　　者：孙勇[1] 赵爱祥 SUN Yong;ZHAO Aixiang(Department of Hepatobiliary and Pancreatic Surgery,Huai'an First People's Hospital,Huai'an,Jiangsu Province,223300 China;Department of General Surgery,Huai'an Industrial Park People's Hospital,Huai'an,Jiangsu Province,223302 China)

机构地区：[1]淮安市第一人民医院肝胆胰外科,江苏淮安223300 [2]淮安工业园区人民医院普外科,江苏淮安223002

出　　处：《系统医学》2021年第23期113-116,共4页Systems Medicine

摘　　要：目的探讨在胆总管结石并发胆管炎患者治疗中,分别以双镜联合胆总管探查取石胆管可控式自脱支架置入一期缝合与T管引流治疗的价值。方法选取2017年1月—2020年12月于该院就医的胆总管结石并发胆管炎患者78例,以术中引流方式分组,常规组(n=39)以T管引流,观察组(n=39)以可控式自脱支架置入胆管内引流一期缝合,统计两组手术指标、术后并发症发生率与疾病复发率。结果观察组手术时间(117.4±45.2)min、腹腔引流管拔除时间(6.7±1.2)d、住院时间(8.2±1.9)d,均低于常规组,差异有统计学意义(t=2.033、4.362、4.045,P<0.05);观察组术中出血量(15.0±4.6)mL、肛门排气时间(23.2±7.5)h,略优于常规组,但差异无统计学意义(t=1.025、1.725,P>0.05)。观察组术后并发症总发生率2.56%低于常规组20.51%,差异有统计学意义(χ^(2)=4.522,P<0.05)。观察组结石和胆管炎复发率为2.56%低于常规组的7.69%,但差异无统计学意义(χ^(2)=0.264,P>0.05)。结论通过以双镜联合胆总管探查取石胆管可控式自脱支架置入一期缝合治疗,可有效缩短患者住院时间,促进其尽快恢复的同时,还能降低患者术后并发症发生风险,且复发率较低,适宜深入研究与推广。Objective To explore the value of double mirrors combined with common bile duct exploration and bile duct controllable self-retracting stent placement in the treatment of common bile duct stones with cholangitis in the treatment of primary suture and T tube drainage.Methods A total of 78 patients with common bile duct stones and cholangitis who were treated in the hospital from January 2017 to December 2020 were selected.They were grouped by intraoperative drainage,the conventional group was drained by T tube,and the observation group was sutured with a controllable self-detaching stent placed in the bile duct for one-stage drainage.The surgical indicators,postoperative complications and disease recurrence rates of the two groups were counted.Results The operation time of the observation group(117.4±45.2)min,the removal time of the abdominal drainage tube(6.7±1.2)d,and the hospitalization time(8.2±1.9)d were lower than those of the conventional group,the difference was statistically significant(t=2.033,4.362,4.045,P<0.05);intraoperative blood loss(15.0±4.6)mL and anal exhaust time(23.2±7.5)h in the observation group were slightly better than the conventional group but the difference was not statistically significant(t=1.025,1.725,P>0.05).The total incidence of postoperative complications in the observation group was 2.56% lower than that of the routine group(20.51%),the difference was statistically significant(χ^(2)=4.522,P<0.05).The recurrence rate of stones and cholangitis in the observation group was 2.56%lower than that of the routine group 7.69%,but the difference was not statistically significant(χ^(2)=0.264,P>0.05).Conclusion One-stage suture therapy with double mirrors combined with common bile duct exploration to remove stones and bile duct controllable self-retracting stents can effectively shorten the patient’s hospital stay,promote their recovery as soon as possible,and reduce the risk of postoperative complications.The recurrence rate is low and it is suitable for in-depth research and promo

关 键 词：胆总管结石 胆管炎 双镜 可控式自脱支架 T管引流 

分 类 号：R657.4[医药卫生—外科学]