腹腔镜胆道探查术胆管一期缝合与T管引流的疗效比较

目的 比较腹腔镜胆道探查术胆管一期缝合与T 管引流两种方法治疗胆囊结石继发胆总管结石患者的疗效.方法 根据腹腔镜胆管探查取石的胆总管内是否放置T管引流,将85例因胆囊结石继发胆总管结石患者分为一期缝合组和T管引流组,比较两组的手术和住院时间、输液量、住院费用、术后恢复情况及手术并发症等.结果 一期缝合组较T管引流组的手术时间及术后住院时间更短、恢复正常工作更快、输液量和住院费用更少(P<0.05),两组手术并发症差异无统计学意义(P>0.05),均无再次手术.结论 腹腔镜胆管探查取石胆管一期缝合避免了放置T 管引起的一系列弊端,体现出微创技术的优越性,治疗适合的胆囊结石继发胆总管结石患者是安全可行的.

Primary duct closure versus T-tube drainage in laparoscopic choledochotomy

Objective To compare the therapeutic effect of primary duct closure and T-tube drainage in laparoscopy choledochotomy for common bile duct stones. Methods Eighty-five patients with cholecystolithiasis and secondary common bile duct stones were treated with laparoscopic choledochotomy. The patients were divided into two groups (primary duct closure group and T-tube drainage group) for comparing the operation time, postoperative hospital stay, postoperative transfusion, hospital costs, and postoperative complications. Results Compared with the T-tube drainage group,the primary duct closure group had less operation time, less total quantity of postoperative transfusion and hospital costs, and shorter postoperative hospital stay. And the patients could come back to work early (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). There was no reoperation in all the patients. Conclusions Primary duct closure in laparoscopic choledochotomy can avoid the deficiency of T-tube drainage. It has obvious advantages, and it is feasible and safe in treating the common bile duct stones.