腹腔镜胆总管探查术后Ι期缝合和T管引流的疗效比较

张海文; 周建鹏; 魏锋; 王广义

doi:10.3969/j.issn.1001-5256.2016.06.026

腹腔镜胆总管探查术后Ι期缝合和T管引流的疗效比较

DOI: 10.3969/j.issn.1001-5256.2016.06.026

吉林大学第一医院肝胆胰外一科

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中图分类号: R657.4
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出版历程
- 出版日期: 2016-06-20

Clinical effect of primary duct closure and T-tube drainage after laparoscopic common bile duct exploration:a comparative analysis

摘要

摘要: 目的比较分析腹腔镜下胆总管探查后胆管Ⅰ期缝合和T管引流的疗效,探讨胆管Ⅰ期缝合的临床应用标准。方法回顾性分析吉林大学第一医院2014年7月-2015年7月间所有胆总管结石患者的临床资料,选择符合纳入标准的患者51例,其中胆总管Ⅰ期缝合26例,T管引流25例,对比分析两组患者在术前术后TBil的变化、胃肠道功能恢复时间、术后第1天腹腔引流管引流量、腹腔引流管拔出时间、并发症、术后住院时间、住院总费用等情况。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果两组患者在术后住院时间、住院总费用等方面差异均有统计学意义（t值分别为-7.067、-3.126,P值分别为<0.001、0.003）。两组患者术后各出现1例并发症,治疗后均痊愈。结论在严格把握手术适应证的基础上,胆总管探查术后胆管Ⅰ期缝合具有住院时间短、费用低、患者生活质量高等优点,安全可行,值得临床推广。
- 胆总管结石 /
- 腹腔镜检查 /
- 缝合技术 /
- 引流术 /
- 对比研究
Abstract: Objective To investigate the effect of primary duct closure and T- tube drainage after laparoscopic common bile duct exploration,as well as the criteria for clinical application of primary duct closure.Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who were treated in The First Hospital of Jilin University from July 2014 to July 2015,and 51 patients who met the inclusion criteria were enrolled.Among these patients,26 underwent primary closure of the common bile duct and 25 underwent T- tube drainage.The change in total bilirubin after surgery,time to recovery of gastrointestinal function,volume of peritoneal drainage at 1 day after surgery,time of removal of peritoneal drainage tube,complications,length of postoperative hospital stay,and total hospital fee were analyzed and compared between the two groups.The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results The length of postoperative hospital stay and total hospital fee showed significant differences between the two groups(t =- 7.067,P < 0.001;t =- 3.126,P = 0.003).One patient in each group experienced a complication and was cured after treatment.Conclusion On the basis of strict control of surgical indications,the primary closure of common bile duct after laparoscopic common bile duct exploration has the advantages of a short length of hospital stay,low hospital fee,and high quality of life,and is safe and feasible.Therefore,it holds promise for clinical application.
- choledocholithiasis /
- laparoscopy /
- suture techniques /
- drainage /
- comparative study

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参考文献(13)

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