Comparative research of laporascopic common bile duct primary suture and T-tube drainage
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摘要: 目的探讨与腹腔镜胆总管T管引流相比,腹腔镜胆总管一期缝合的优点,手术操作的技术关键,手术适应证以及并发症的预防。方法回顾对照分析2008年7月至2010年7月间行腹腔镜胆总管一期缝合的24例患者以及同期行腹腔镜T管引流的24例患者的临床病历资料,分为一期缝合组和T管引流组。结果一期缝合组与T管引流组的平均手术时间分别为(54.03±8.46)、(49.83±7.25)min,术中出血量分别为(15.13±4.26)、(16.23±5.25)ml,两组差异无统计学意义(P>0.05)。而一期缝合组与T管引流组的首次肛门排气时间分别为(1.16±0.46)与(2.02±0.19)d、术后补液量分别为(8.05±2.73)与(11.56±4.72)L、术后住院时间分别为(7.73±1.76)与(13.85±4.09)d、住院费用分别为(11 393±283)与(15 836±296)元,带管时间分别为(6.45±2.15)与(73.68±9.15)d。一期缝合组的平均带管时间较T管引流组缩短(67.23±7)d。以上观察指标,两组差异有统计学意义(P<0.01)。一期缝合组4例术...Abstract: Objective To study the advantages,the key techniques,indications and complications of common bile duct primary suture.Methods To review 24 cases of primary suture and 24 cases of T-tube drainage from July in 2008 to July in 2010 of the first hospital of Jilin university.Results The mean operation time and bleeding volume of the primary suture and T-tube drainage were(54.03±8.46)min and(49.83±7.25)min,(15.13±4.26)ml and(16.23±5.25)ml respectively.The difference wasn't significant statistically.The first exhaust time of the two groups were(1.16±0.46)d and(2.02±0.19)d,fluid infusion volume were(8.05±2.73)L and(11.56±4.72)L,hospital stay time were(7.73±1.76)d and(13.85±4.09)d,hospital charges were $(11393±283) and $(15836±296),drainage time were(6.45±2.15)d and(73.68±9.15)d.All indexes were significant statistically.In primary suture group no remnant stones exist in common bile duct.Bile leakage occurred in 4 cases without complications.All cases were cured.Relapse of stones and bile duct stricture were not seen within 1 month to 2 years follow-up.Conclusion Primary suture can help patients' rapid recovery.No remnant stones in common bile duct is the premise factor.Following strict operation indications and operation technique are the keys to get the best result.
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Key words:
- cholecystectomy /
- laparoscopic /
- drainage
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