腹腔镜胆总管切开探查一期缝合与“T”管引流的对比研究

目的:对比分析腹腔镜胆总管切开探查取石术后一期缝合胆总管与置"T"管引流的疗效。方法:回顾分析我院2003年2月至2008年2月为78例胆总管结石患者行腹腔镜胆总管切开探查取石术的临床资料,其中一期缝合35例,"T"管引流43例。比较两组的手术时间、术中出血量、肛门排气时间、术后住院时间及手术并发症发生率。结果:两组患者手术时间、术中出血量及并发症发生率差异无统计学意义(P>0.05)。一期缝合组的肛门排气时间、术后住院时间均短于"T"管引流组,两组差异有统计学意义(P<0.05)。结论:在严格掌握一期缝合适应证的条件下,腹腔镜胆总管切开探查后一期缝合较"T"管引流疗效更好。

The comparative study between primary closure and T-tube drainage after laparoscopic common bile duct exploration

Objective:To compare the clinical effect between primary closure and T-tube drainage after laparoscopic common bile duct exploration.Methods:The clinical data of 78 cases of choledocholithiasis received laparoscopic common bile duct exploration as treatment from Feb.2003 to Feb.2008 were analyzed retrospectively,among which primary closure was used in 35 cases and T-tube drainage was used in 43 cases.The operative time,intraoperative blood loss,normal gastrointestinal activity recovery time,hospital stay after surgery and the incidence of postoperative complications were compared between the two groups.Results:There were no statistical differences in the operative time,intraoperative blood loss and the incidence of postoperative complications between two groups(P>0.05).In primary closure group,the time of gastrointestinal activity recovery and the hospital stay after surgery were shorter than that in T-tube drainage group,the differences between the two groups were statistically significant(P<0.05).Conclusions:If the indication of primary closure was strictly mastered,the clinical effect of primary closure was better than T-tube drainage after laparoscopic common bile duct exploration.