一期缝合与T管引流在腹腔镜胆总管探查取石术联合胆囊切除术中的应用效果比较  

Comparison of application effects of primary suture and T-tube drainage in laparoscopic common bile duct exploration combined with cholecystectomy

作　　者：郑跃 ZHENG Yue(Department of General Surgery of Xiamen Fifth Hospital,Xiamen 361100 Fujian,China)

机构地区：[1]厦门市第五医院普外科,福建厦门361100

出　　处：《中国民康医学》2024年第22期138-140,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较一期缝合与T管引流在腹腔镜胆总管探查取石术(LCBDE)联合胆囊切除术(LC)中的应用效果。方法:回顾性分析2019年1月至2024年1月该院收治的90例行LCBDE联合LC患者的临床资料,按胆总管壁处理方式不同分为T管引流组(43例)、一期缝合组(47例)。T管引流组采用T管引流方式处理胆总管壁,一期缝合组采用一期缝合方式处理胆总管壁,比较两组手术时间、术中出血量、术后肛门首次排气时间、住院时间、血清炎性指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、血清应激指标[皮质醇、促肾上腺皮质激素(ACTH)]水平和并发症发生率。结果:一期缝合组术后肛门首次排气时间、住院时间均短于T管引流组,差异有统计学意义(P<0.05);术后24 h,两组血清IL-6、CRP等血清炎性指标水平和皮质醇、ACTH等血清应激指标水平均高于术前,但一期缝合组低于T管引流组,差异有统计学意义(P<0.05);术后1个月,一期缝合组并发症发生率为8.51%,低于T管引流组的25.58%,差异有统计学意义(P<0.05);两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05)。结论:一期缝合应用于LCBDE联合LC可缩短术后肛门首次排气时间和住院时间,以及降低血清炎性指标水平、血清应激指标水平和术后并发症发生率,效果优于T管引流。Objective:To compare effects of primary suture and T-tube drainage in laparoscopic common bile duct exploration(LCBDE)combined with cholecystectomy(LC).Methods:The clinical data of 90 patients who underwent LCBDE combined with LC in the hospital from January 2019 to January 2024 were retrospectively analyzed.According to the different treatment methods of common bile duct wall,they were divided into T-tube drainage group(43 cases)and primary suture group(47 cases).The T-tube drainage group used T-tube drainage to treat the common bile duct wall,while the primary suture group used primary suture to treat the common bile duct wall.The operation time,the intraoperative blood loss,the postoperativefirst anal exhaust time,the hospitalization time,the serum inflammatory indexes[interleukin-6(IL-6),C-reactive protein(CRP)]levels,the serum stress indexes[cortisol,adrenocorticotropic hormone(ACTH)]levels,and the incidence of complications were compared between the two groups.Results:Thefirst anal exhaust time and the hospitalization time in the primary suture group were shorter than those in the T-tube drainage group,and the differences were statistically significant(P<0.05).At 24 h after the surgery,the levels of serum inflammatory indexes such as IL-6 and CRP and serum stress indexes such as cortisol and ACTH in the two groups were higher than those before operation,but those in the primary suture group were lower than those in the T-tube drainage group,and the differences were statistically significant(P<0.05).One month after the surgery,the incidence of complications in the primary suture group was 8.51%,which was significantly lower than 25.58%in the T-tube drainage group,and the difference was statistically significant(P<0.05).However,there was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).Conclusions:The application of primary suture in LCBDE combined with LC can shorten thefirst anal exhaust time and the hospitalization time after the surgery,and reduce th

关 键 词：一期缝合 T管引流 腹腔镜胆总管探查取石术 胆囊切除术 应激 

分 类 号：R575[医药卫生—消化系统]