腹腔镜胆总管探查术后内引流在细径胆总管结石患者中的应用  

Application of intrabiliary drainage after laparoscopic common bile duct exploration in patients with fine diameter common bile duct stones

作　　者：吴东东 董浩 王尚毓 马富平 WU Dongdong;DONG Hao;WANG Shangyu(Department of Hepatobiliary Surgery,Xianyang Central Hospital,Xianyang 712000,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Air Force Military Medical University)

机构地区：[1]咸阳市中心医院肝胆外科,陕西咸阳712000 [2]空军军医大学第一附属医院肝胆外科

出　　处：《腹腔镜外科杂志》2023年第12期911-915,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜胆总管探查取石术后胆管内引流方式应用于细径胆总管结石患者中的可行性与安全性。方法:回顾分析2019年1月至2021年12月收治的112例细径胆总管结石合并胆囊结石患者的临床资料。依据胆管引流方式分为内引流组(n=52)与外引流组(n=60),比较两组术前临床资料及术中、术后相关指标。结果:两组患者术前临床资料差异无统计学意义。两组手术时间、术中出血量、引流管放置时间、住院总花费、术后胆漏、残余结石发生率差异无统计学意义(P>0.05)。内引流组术后排气时间[(2.4±0.8)d vs.(3.4±0.9)d]、术后住院时间[(7.4±0.8)d vs.(10.4±0.9)d]短于外引流组,术后电解质紊乱发生率低于外引流组(1 vs.8),差异有统计学意义(P<0.05)。结论:腹腔镜胆总管探查取石术后胆管内引流方式应用于细径胆总管结石患者中是安全、可行的,可减少术后电解质紊乱的发生,加速术后康复。Objective:To explore the feasibility and safety of intrabiliary drainage in patients with fine diameter common bile duct stones after laparoscopic choledocholithotomy.Methods:The clinical data of 112 patients with fine diameter common bile duct stones combined with gallbladder stones admitted from Jan.2019 to Dec.2021 were retrospectively analyzed.According to different biliary drainage methods,patients were divided into internal drainage group(n=52)and external drainage group(n=60).The preoperative baseline data,intraoperative and postoperative related indicators of the two groups were compared.Results:There was no statistically significant difference between the two groups in preoperative baseline data,surgical time,intraoperative blood loss,drainage retention time,total hospitalization cost,postoperative biliary leakage,and residual stone incidence(P>0.05).Compared with the external drai-n age group,the internal drainage group had faster postoperative exhaust[(2.4±0.8)d vs.(3.4±0.9)d],shorter postoperative hospital stay[(7.4±0.8)d vs.(10.4±0.9)d],and lower incidence of postoperative electrolyte disturbances(1 vs.8),with statistically significant differences(P<0.05).Conclusions:The application of intrabiliary drainage after laparoscopic common bile duct exploration is safe and feasible,which can reduce the occurrence of postoperative electrolyte disorders and accelerate the postoperative recovery of patients.

关 键 词：胆总管结石病 胆总管探查 腹腔镜检查 内引流 细胆总管 

分 类 号：R657.4[医药卫生—外科学]