胆道冲洗装置在腹腔镜胆总管切开取石术中的应用体会  

Application of biliary flushing device in laparoscopic choledocholithotomy

作　　者：雷文俤 常贵建 卓信斌 林德新 LEI Wendi;CHANG Guijian;ZHUO Xinbin(Department of Hepatobiliary-Pancreatic-Splenic Surgery,Ningde City Hospital Affiliated to Ningde Normal University,Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院肝胆胰脾外科,福建宁德352100

出　　处：《腹腔镜外科杂志》2023年第8期604-608,共5页Journal of Laparoscopic Surgery

基　　金：福建省自然科学基金(2021J011164)。

摘　　要：目的:总结胆道冲洗装置在腹腔镜胆总管切开取石术中的应用经验、可行性、安全性及有效性。方法:回顾分析2019年11月至2022年11月为82例胆总管结石患者行腹腔镜胆总管切开取石术的临床资料。根据术中是否应用胆道冲洗装置,分为胆道冲洗装置组(观察组,n=40)与非胆道冲洗装置组(对照组,n=42),比较两组手术时间、术中出血量、术后住院时间、术后并发症发生率、术后结石复发率、住院费用、手术费用等指标。结果:观察组手术时间短于对照组,差异有统计学意义[(105.4±14.2)min vs.(113.7±15.5)min,P=0.014];两组术中出血量[(27.3±9.2)mL vs.(29.1±6.6)mL,P=0.309]、术后住院时间[(7.3±1.0)d vs.(7.4±1.0)d,P=0.631]、术后并发症发生率[7.5%(3/40)vs.7.1%(3/42),P=0.720]、术后结石复发率[5.0%(2/40)vs.4.8%(2/42),P=0.960]、住院费用[(27409.4±6304.9)元vs.(27688.8±5534.6)元,P=0.831]、手术费用[(6586.1±874.4)元vs.(6351.0±828.8)元,P=0.215]差异均无统计学意义。结论:自制胆道冲洗装置操作简便,成本低,可缩短手术时间,且不会增加手术费用及并发症,实用、安全、有效。Objective:To summarize the application experience,feasibility,safety and effectiveness of the biliary flushing d evice in laparoscopic choledocholithotomy.Methods:The clinical data of 82 patients with choledocholithiasis who underwent laparoscopic choledocholithotomy between Nov.2019 and Nov.2022 were retrospectively analyzed.Patients were divided into the biliary flushing device group(n=40)and the non-biliary flushing device group(n=42)according to different treatment methods.The operative time,intraoperative blood loss,postoperative hospital stay,incidence of postoperative complications,postoperative calculi recurrence rate,hospitalization expenses and surgery costs in the two groups were compared and analyzed.Results:The operative time[(105.4±14.2)min vs.(113.7±15.5)min,P=0.014]was shorter in the biliary flushing device group than that in the non-biliary flushing d evice group,with a statistically significant difference(P<0.05).And the intraoperative blood loss[(27.3±9.2)mL vs.(29.1±6.6)mL,P=0.309],postoperative hospitalization time[(7.3±1.0)d vs.(7.4±1.0)d,P=0.631],postoperative complication rate[7.5%(3/40)vs.7.1%(3/42),P=0.720],postoperative calculi recurrence rate[5.0%(2/40)vs.4.8%(2/42),P=0.960],hospitalization expenses[(27409.4±6304.9)yuan vs.(27688.8±5534.6)yuan,P=0.831],and surgery costs[(6586.1±874.4)yuan vs.(6351.0±828.8)yuan,P=0.215]were not statistically significantly different between the 2 groups.Conclusions:The self-made biliary flushing device is easy to operate and could reduce the operation time.It is economical,practical,safe,effective,and does not i ncrease the operation cost and complications.

关 键 词：胆总管结石病 胆总管切开取石术 腹腔镜检查 胆道镜检查 胆道冲洗装置 

分 类 号：R657.4[医药卫生—外科学]