胆总管探查后一期缝合术的疗效评价

目的:评价胆总管探查后一期缝合的临床效果。方法:胆总管结石患者按手术先后顺序分为两组,各33例,胆总管探查后分别行胆总管一期缝合术和T形管引流术,比较两组的术后并发症发生率和术后住院天数。结果:胆总管一期缝合组:泌尿系感染1例,切口皮下脂肪液化1例,术后食欲不振、乏力1例,1例术后腹腔引流管有少量的胆汁,术后平均住院天数(8.89±1.43)d;T形管引流组:切口皮下脂肪液化3例,术后食欲不振、乏力7例,3例术后腹腔引流管有少量的胆汁,术后平均住院天数(12.23±2.36)d。两组比较在胆道有关的并发症发生率上差异无显著意义(P>0.05),而在治愈天数、其他并发症发生率方面差异有显著意义(P<0.05)。结论:在正确选择适应症的前提下,胆总管一期缝合术是安全有效的术式,比T形管引流术有明显的优点。

The clinical assessment on primary suture after choledochotomy in open operation

Objective To evaluate the clinical value of primary suture after choledochotomy in open operation. Method 66 cases with choledochal stone were randomized into two groups by operation in turn: primary suture after choledochotomy in open operation (PS) and T-tube drainage for choledochotomy in open operation(TD) groups.The complications and in-patient days were compared to between above two groups. Results One case had urinary infection in PS group.Subcutaneous fit necrosis occurred in one patient of PS group and 3 patients of TD group.poor appetite occurred in one patient of PS group and 7 patients of TDgroup.biliary kek occurred in one patient of PS group and 3 patients of TD group .There was no significant difference in complications related with bile duck between PS and TD groups (P>0.05),but the difference of the other complications and in-patient days were statistically significant between PS and TD groups(P<0.01,P<0.05,respectively). Conclusion The primary suture after choledochotomy is a safe.effec-tive operation way when patents were chosen reasonably and had the advantage of the T-tube drainage.