文章摘要
腹腔镜胆总管探查一期缝合与T管引流治疗胆囊结石合并胆总管结石的疗效对比
A comparative study on the efficacy of primary duct closure and T-tube drainage in the treatment of cholecystolithiasis complicated with choledocholithiasis in laparoscopic common bile duct exploration (LCBDE)
投稿时间：2022-05-19  
DOI：10.3969/j.issn.1000-0399.2023.04.005
中文关键词: 胆囊结石  胆总管结石  腹腔镜胆总管探查术  一期胆管缝合术  胆管内置T管外引流术
英文关键词: Cholecystolithiasis  Choledocholithiasis  Laparoscopic common bile duct exploration  primary duct closure  T-tube drainage
基金项目:安徽医科大学青年科学基金(编号：2021xkj084)
作者单位E-mail
滕达 239001 安徽滁州 安徽医科大学附属滁州医院肝胆胰脾外科一病区  
许悦 239001 安徽滁州 安徽医科大学附属滁州医院超声医学中心  
章伟 239001 安徽滁州 安徽医科大学附属滁州医院肝胆胰脾外科一病区  
杨青松 239001 安徽滁州 安徽医科大学附属滁州医院肝胆胰脾外科一病区 344482560@qq.com 
摘要点击次数: 996
全文下载次数: 314
中文摘要:
      目的 比较腹腔镜胆总管探查（LCBDE）一期胆管缝合术与胆管内置T管外引流术治疗胆囊结石合并胆总管结石的疗效及安全性。方法 回顾性分析2019年1月至2021年1月安徽医科大学附属滁州医院肝胆胰脾外科一病区因胆囊结石合并胆总管结石接受LCBDE术104例患者的临床资料。按照胆总管处理方式的不同分为一期胆管缝合组（PDC组）和胆管内置T管外引流组（TTD组），其中PDC组53例，TTD组51例。比较两组患者结石数量、大小、胆总管直径分布、取石成功率、术后肝功能指标、手术时间、温氏孔引流量、引流管留置时间、术后住院时间、治疗费用和术后并发症情况。结果 两组患者的结石数量、大小、取石成功率比较，差异均无统计学意义（P>0.05）。两组患者手术前后肝功能变化值的差异无统计学意义（P>0.05）。两组患者胆总管直径分布情况比较，差异有统计学意义（χ2=14.253，P< 0.05）。PDC组的手术时间、温氏孔引流量、引流管留置时间、术后住院时间和总治疗费用均优于TTD组，差异有统计学意义（P< 0.05）。两组患者术后结石残余、出血、急性胰腺炎、胆漏、急性胆管炎、胆道狭窄和结石复发比较，差异均无统计学意义（P>0.05）。PDC组术后电解质紊乱发生率低于TTD组，差异有统计学意义（P< 0.05）。结论 相较于留置T管，LCBDE术后胆管一期缝合可减少手术创伤，加速术后康复和降低术后并发症。
英文摘要:
      Objective To compare the efficacy and safety of laparoscopic common bile duct exploration (LCBDE) primary duct closure and T-tube drainage in the treatment of cholecystolithiasis complicated with choledocholithiasis. Methods The clinical data of 104 patients from January 2019 to January 2021 were analyzed retrospectively, who underwent LCBDE for cholecystolithiasis complicated with choledocholithiasis in Department of Hepatobiliary Pancreatic and Splenic Surgery Ward Ⅰ, the Affiliated Chuzhou Hospital of Anhui Medical University. According to the different treatment methods of common bile duct, they were divided into primary duct closure or T-tube drainage group. There were 53 cases in PDC group and 51 cases in TTD group. The number, size, diameter distribution of common bile duct, success rate of stone removal, liver function indexes after operation, operation time, drainage tube retention time, postoperative hospitalization time, treatment cost and postoperative complications were compared between the two groups. Results There was no significant difference in the number, size, success rate of stone removal between the two groups (P>0.05). There was no statistically significant difference in liver function changes between the two groups before and after surgery (P>0.05). The difference in the distribution of common bile duct diameter was statistically significant in the two groups of patients (χ2=14.253，P< 0.05). The operation time, drainage tube retention time, postoperative hospitalization time and total treatment cost of PDC group were better than those of TTD group (P< 0.05). There was no significant difference in residual stone, bleeding, acutepancreatitis, bile leakage, acute cholangitis, biliary stricture and stone recurrence between the two groups (P>0.05). The incidence of electrolyte disorder in PDC group was lower than that in TTD group (P< 0.05) Conclusions Compared with T-tube drainage, primary duct closure after LCBDE can reduce surgical trauma, accelerate postoperative recovery and reduce postoperative complications.
查看全文   查看/发表评论  下载PDF阅读器
关闭