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腹腔镜胆管探查术Ⅰ期缝合与 T 管引流治疗胆总管结石的疗效比较
乔刚,杜庆云,韩恩崑,赵宏志,杨连营
0
天津市宝坻区人民医院肝胆外科 / 天津医科大学宝坻临床学院肝胆外科 ( 天津 301800);天津市南开医院微创外科(天津 300110)
摘要:
目的:比较腹腔镜胆总管探查取石术后 I 期缝合与 T 管引流治疗胆总管结石患者的临床治疗效果。方法:选取2015 年 5 月—2017 年 5 月就诊于我院成功进行腹腔镜手术治疗胆总管结石并获得完整随访资料的患者 77 例,并对其此两种不同术式的手术时间、术后胃肠功能恢复时间、术后住院时间、术后并发症、残余结石率进行比较分析。结果:I 期缝合组手术时间、术后胃肠道功能恢复时间及术后住院时间分别为(109.22±23.10) min、(10.65±3.32) h、(5.12±2.73) d,均显著低于 T 管引流组(125.28±28.38) min、(14.05±3.52) h、(11.23±3.18) d,差异具有统计学意义(P < 0.05),I期缝合组与 T 管引流组术后并发症发生率无显著差异,无统计学差异(P > 0.05)。结论:腹腔镜胆管切开取石术后 I 期缝合胆管的治疗效果优于 T 管引流术,两者均具有临床安全有效性,在不同适应证前提下应根据患者的个体情况进行选择。
关键词:  腹腔镜胆管探查术  I 期缝合  T 管引流
DOI:10.3969/j.issn.1007-6948.2019.06.034
基金项目:
Comparison on Efficacy of Laparoscopic Common Bile Duct Exploration with Primary Suture and T-tube Placement in Treatment of Common Bile Duct Stones
QIAO Gang,,DU Qing-yun,HAN En-kun
Department of Hepatobiliary Surgery, Tianjin Baodi District People' s Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin (301800), China.
Abstract:
Objective To compare the effectiveness of laparoscopic common bile duct exploration with primary suture and T-tube placement in the treatment of common bile duct stones. Methods From May 2015 to May 2017, 77 patients with completed follow-up data treated by laparoscopic common bile duct exploration with T-tube or primary suture were included in this study. Results The operation time, recovery time of gastrointestinal function and postoperative hospitalization time of primary suture group were (109.22+23.10) min, (10.65+3.32) h, and (5.12+2.73) d, which were significantly lower than those of T tube group [(125.28±28.38) min, (14.05±3.52) h, (11.23±3.18) d], there was statistically significant difference (P<0.05). There was no significant difference in the incidence of complications between primary suture group and T tube group (P>0.05). Conclusion Laparoscopic common bile duct exploration with primary suture is better than T tube placement on the clinical effects, both of them are safe and effective, and it should be selected according to the individual condition of patients under different indications.
Key words:  Laparoscopic common bile duct exploration  primary suture  T-tube placement

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