腹腔镜胆总管探查一期缝合术中放置定时脱落的J形导管行胆道内引流的效果观察  

Observation on the Effect of Internal Biliary Drainage by Placing a J-shaped Catheter Detached Regularly during Primary Suture of Laparoscopic Common Bile Duct Exploration

作　　者：杨荣彬[1] YANG Rong-bin(Department of Hepatobiliary,Pancreatic and Splenic Surgery,Jiangmen Central Hospital,Jiangmen,Guangdong 529030)

机构地区：[1]广东省江门市中心医院肝胆胰脾外科,广东江门529030

出　　处：《智慧健康》2021年第28期120-122,共3页Smart Healthcare

摘　　要：目的 探讨腹腔镜胆总管探查一期缝合术中放置定时脱落的J形导管行胆道内引流的临床效果。方法 选取2018年11月-2021年8月广东省江门市中心医院收治的胆总管结石患者76例作为研究对象,按照随机数字表法将患者分成观察组(n=38)与对照组(n=38),对照组使用腹腔镜胆总管探查一期缝合术治疗,观察组在对照组的基础上采用定时脱落的J形导管行胆道内引流治疗,两组均进行腹腔镜胆总管探查,对两组围术期情况、术后并发症情况及生活质量进行比较。结果 观察组手术时间、首次排气时间、住院时间较对照组均明显更短(P<0.05),手术出血量较对照组明显更少(P<0.05);观察组并发症发生率较对照组明显更低(P<0.05);与术前相比,术后两组胃肠道生活质量指数(GIQLI)评分均有明显提高(P<0.05),观察组GIQLI评分较对照组明显更高(P<0.05)。结论 在腹腔镜胆总管探查一期缝合术中应用定时脱落的J形导管行胆道内引流能够提高围术期临床效果,降低并发症发生率,提高患者的生活质量。Objective To investigate the clinical effect of internal biliary drainage by placing a J-shaped catheter that was detached regularly during primary suture of laparoscopic common bile duct exploration.Methods 76 patients with choledocholithiasis admitted to Jiangmen Central Hospital from November 2018 to August 2021 were selected as the research subjects.According to the random number table method,the patients were divided into the observation group (n=38) and the control group (n=38).The control group was treated with laparoscopic choledocholithiasis one-stage suture.On the basis of the control group,the observation group was treated with internal biliary drainage with a J-shaped catheter that was peeled regularly.Laparoscopic common bile duct exploration was performed in both groups.The perioperative conditions,postoperative complications and quality of life of the two groups were compared.Results Compared with the control group,the operation time,the first exhaust time and the hospitalization time of the observation group were significantly shorter (P<0.05),and the operative blood loss was significantly less (P<0.05).The incidence of complications in observation group was significantly lower than that in control group (P<0.05).Compared with pre-operation,gastrointestinal quality of life index (GIQLI) score in both groups significantly increased after operation (P<0.05),and GIQLI score in the observation group was significantly higher than that in the control group (P<0.05).Conclusion The application of J-shaped catheter to biliary drainage during primary suture in laparoscopic common bile duct exploration can improve the perioperative clinical effect,reduce the incidence of complications and improve the quality of life of patients.

关 键 词：腹腔镜胆总管探查 一期缝合术 J形导管 定时脱落 胆道内引流 

分 类 号：R657.4[医药卫生—外科学]