顺行鼻胆管应用在腹腔镜胆道探查胆总管一期缝合术中的可行性及安全性分析  

Feasibility and Safety Analysis of Anterograde Nasal Bile Duct in Primary Suture of Laparoscopic Common Bile Duct Exploration

作　　者：苏宗毅 SU Zongyi(Department of General Surgery,Xinglin Branch,the First Affiliated Hospital of Xiamen University,Xiamen City,Fujian Province 361000)

机构地区：[1]厦门大学附属第一医院杏林分院普外科,福建省厦门市361000

出　　处：《医学理论与实践》2022年第12期1993-1996,共4页The Journal of Medical Theory and Practice

摘　　要：目的:研究顺行鼻胆管应用在腹腔镜胆道探查胆总管一期缝合术中的可行性及安全性。方法:选取我院2018年6月—2020年6月符合腹腔镜胆道探查术指征的胆囊结石伴有胆总管结石患者120例,按照随机数字表法分为对照组(60例)和研究组(60例)。对照组予以留置T管引流,研究组予以顺行鼻胆管引流联合胆总管一期缝合术。比较两组患者术中与术后恢复情况、术后胆汁引流情况、营养状况、肝功能、并发症总发生率。结果:两组患者手术时间、术中出血量均无显著差异(P>0.05),研究组引流管放置时间、肛门排气恢复时间均短于对照组(P<0.05)。两组患者术后第2天及第3天胆汁引流量均较术后第1天降低,且研究组术后第2天及第3天胆汁引流量均低于对照组(P<0.05)。术后1周两组患者PA、HGB、ALB均较术前降低,但研究组均高于对照组(P<0.05)。术后1周两组患者ALT、GGT、DBIL均较术前降低,且研究组均低于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论:顺行鼻胆管应用于腹腔镜胆道探查胆总管一期缝合术中,可利于患者恢复,减少引流量,改善营养状况,促进肝功能恢复,且安全性较好。Objective:To study the feasibility and safety of the application of anterograde nasal bile duct in the primary suture of laparoscopic common bile duct exploration.Methods:From June 2018 to June 2020,120 patients with gallbladder stones and choledocholithiasis who met the indications for laparoscopic biliary exploration were divided into control group(60 cases)and study group(60 cases)according to the random number table.The control group received indwelling T tube drainage,and the study group received anterograde nasobiliary drainage combined with primary suture of the common bile duct.Intraoperative and postoperative recovery,postoperative bile drainage,nutritional status,liver function,and total incidence of complications were compared between the two groups.Results:There was no difference in operation time and intraoperative blood loss between the two groups(P>0.05).The drainage tube placement time and anal exhaust recovery time in the study group were shorter than those in the control group(P<0.05).The postoperative bile drainage volume of the two groups of patients on the second and third postoperative days were lower than that on the first postoperative day,and the postoperative bile drainage volume of the study group on the second and third postoperative days were lower than that of control group on the first postoperative day(P<0.05).The PA,HGB,and ALB of the two groups on 1 week after operation were lower than that before operation,but the study group were higher than those of the control group(P<0.05).1 week after operation,ALT,GGT,and DBIL of the two groups were lower than those before operation,and those of the study group were lower than the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:The anterograde nasal bile duct is used in patients with primary suture of the common bile duct in laparoscopic biliary exploration,which can help patients recover,reduce drainage,improve nutritional status,promote liver functi

关 键 词：顺行鼻胆管 腹腔镜胆道探查 胆总管一期缝合术 肝功能 

分 类 号：R657.42[医药卫生—外科学]