胆总管结石首次即行内引流术的临床研究

目的　探讨胆总管结石首次即行内引流术的可行性。方法　选择管径 >1 5cm的胆总管结石患者 2 2 4例 ,随机分为内引流术组 (治疗组 ) 12 2例和T管引流术组 (对照组 )10 2例 ,进行前瞻性对比分析。结果　治疗组出现近期并发症 15例 ,远期并发返流性胆管炎 6例 ,再发结石 3例 ,均在局麻下行胆道镜取石及对症治疗而痊愈。对照组近期并发症10例 ,远期并发胆管炎 2 4例 ,再发结石 2 3例 ,2 3例均行二次手术 ,改行内引流术 2 0例 ,3例因病重而再行T管引流 ,死亡 2例。结论　对管径 >1 5cm的胆总管结石宜首次即行内引流术。

Clinical study on the biliointestinal internal drainage operation as primary procedure for choledocholithiasis

Objective To evaluate the availability of the biliointestinal internal drinage operation(BIIDO) as a primary procedure for choledocholithiasis. Methods 224 cases of choledochlithiasis in common bile duct(CBD) diameter beyond 1.5?cm were divided randomly into two groups: (1)BIIDO group (B group), 122 cases. (2) T tube drainage group(T group), 102 cases. The clinical data of patients of the 2 groups were prospectively analyzed and compared. Results In B group, postoperative complications occurred in 15 cases; in follow up peried, stone recurrence was found in 3 cases, and reflux cholangitis in 6 cases. In T group, postoperative complications occurred in 10 cases, reflux cholangitis in 24 cases and stone recurrence in 23 cases. Conclusions For those patients with choledocholithiasis, if their CBD diamter beyond 1.5?cm, the BIIDO as a primary procedure should be considered.