摘要
目的探讨腹腔镜胆总管切开取石术(LCBDE)中胆总管的常见几种处理方式的疗效。方法胆总管结石行LCBDE病人306例,根据不同的手术方式分别为双J管组102例,胆总管一期缝合组106例,T管引流组98例,比较三组间手术、围手术期和术后并发症情况。结果三组病人均顺利完成手术,其中T管引流组手术时间最长,为(129.3±12.24)分钟,胆总管一期缝合组最短,为(105.1±5.93)分钟;T管引流组术后住院时间最长,为(10.8±1.42)天,双J管引流组其次,为(10.2±1.41)天,胆总管一期缝合组最短,为(8.7±1.50)天;T管引流组术后排气时间最长,为(4.65±0.91)天,胆总管一期缝合组最短,为(2.64±1.07)天;总住院费用中T管引流组最多,为(25278.0±294.71)元,胆总管一期缝合组总费用最低,为(16727.5±193.52)元。三组比较差异具有统计学意义(P<0.05)。双J管引流组、胆总管一期缝合组、T管引流组术后并发症发生率分别为4.9%,5.6%和2.0%,差异无统计学意义(P>0.05)。结论LCBDE术中胆总管的一期缝合临床可行,但需要严格把握手术指证,必要时行胆总管T管置入。
Objective To explore the common methods of treatment of laparoscopic common bile duct stone exploration.Methods There were 306 cases of common bile duct stones treated with LCBDE.The clinical data of patients undergoing laparoscopic common bile duct incision and lithotripsy will be divided into three groups according to different surgical methods:double J tube group(102 cases),common bile duct primary suture group(106 cases),T tube drainage group(98 cases).Operative,perioperative and postoperative complications were compared among the three groups.Results All patients completed the operation successfully.The T-tube placement group had a longer operation time[(129.3±12.24)min],the primary suture group of common bile duct was the shortest[(105.1±5.93)min];longer hospital stay[(10.8±1.42)d],double J tube drainage group followed[(10.2±1.41)d],the primary suture group of common bile duct was the shortest[(8.7±1.50)d].The T-tube placement group had the longest postoperative exhaust time[(4.65±0.91)d],the primary suture group of common bile duct was the shortest[(2.64±1.07)d].The T-tube placement group was the largest group in the total hospitalization cost[(25278.0±294.71)yuan],,the primary suture group of common bile duct was the shortest[(16727.5±193.52)yuan].The differences between the three groups were statistically significant(P<0.05).The Incidence of postoperative complications of double J tube group,common bile duct primary suture group and T tube drainage group were 4.9%,5.6%and 2.0%,respectively(P>0.05).Conclusion The primary suture of the common bile duct during LCBDE is clinically feasible.However,it is necessary to strictly control the surgical indication.If necessary,the T-tube of the common bile duct should be inserted.
作者
杜京丽
郭庆森
郑茂煌
刘益峰
吴德柱
DU Jingli;GUO Qingsen;ZHENG Maohuang(Department of General Surgery,the Chinese People's Liberation Army No.95 Hospital,Putian 351100,China)
出处
《临床外科杂志》
2019年第8期664-667,共4页
Journal of Clinical Surgery
关键词
胆总管结石
腹腔镜
T管置入术
双J管
一期缝合
common bile duct stones
laparoscopic
T-tube placement
double J tube
one-stage suture
