摘要
目的:探讨腹腔镜联合胆道镜胆总管探查一期缝合与T管引流两种手术方式的特点,评估其可行性与安全性。方法:回顾分析2010年2月至2014年10月203例行腹腔镜胆囊切除、胆总管探查术患者的临床资料,其中88例(43.3%)患者术中放置T管引流(T管组),115例(56.7%)患者采用一期缝合(缝合组)。结果:两组患者一般情况差异无统计学意义,缝合组手术时间、术中出血量、胃肠功能恢复时间、术后住院时间、残留结石率小于T管组(P<0.05),术后胆漏发生率高于T管组(P=0.035),术后出血、感染、复发率两组相比差异无统计学意义。两组均无胆管狭窄发生。结论:腹腔镜胆总管探查一期缝合术的手术效果及术后恢复情况优于T管引流,但其胆漏率高于T管引流。
Objective： To compare the different characters between the primary suture and T-tube drainage after laparoscopic and choledochoscopic common bile duct exploration,and evaluate the feasibility and the security. Methods： The clinical data of 203 patients who received laparoscopic cholecystectomy and common bile duct exploration from Feb. 2010 to Oct. 2014 were retrospectively analyzed,among which primary closure was used in 115 cases and T-tube drainage was used in 88 cases. Results： There were no differences in the demographic characteristics or clinical presentations between the two groups. Compared with the T-tube group,the operative time,intraoperative blood loss,postoperative gastrointestinal function recovery time,postoperative hospital stay and the incidences of residual stones were significantly less and the incidence of bile leakage was significantly higher in the primary closure group（ P =0. 035）. There were no statistical differences in the incidences of postoperative bleeding,infection or recurrence of calculi between two groups. No bile duct stenosis occurred in both groups. Conclusions： In the effect of operation and the postoperative recovery,the primary closure is better than the T-tube drainage after laparoscopic common bile duct exploration. But the incidence of bile leakage is higher in the primary closure patients.
作者
李昌龙
刘东斌
徐大华
刘家峰
王悦华
梁阔
仝小刚
郑亚民
李非
LI Chang-long LIU Dong-bin XU Da-hua et al(Department of General Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China)
出处
《腹腔镜外科杂志》
2016年第11期846-849,共4页
Journal of Laparoscopic Surgery
基金
人社部留学人员科技活动择优资助项目(编号:008-0095)
关键词
胆总管结石
胆囊结石病
胆总管探查术
腹腔镜检查
一期缝合
T管引流
Choledocholithiasis
Cholecystolithiasis
Common bile duct exploration
Laparoscopy
Primary suture
T-tube drainage
