鼻胆管替代T管在老年胆道外科中的应用

目的 研究鼻胆管代替T管在胆总管切开后一期缝合中的作用。方法 ERCP后置入鼻胆管引流，手术中行胆总管切开取石后一期缝合胆总管，共26例。结果（1）患者术后住院天数明显减少（P＜0．01）。胆总管切开放置T管的患者，术后至少2周以上才能拔除T管，有时为了防止胆漏的发生，T管放置时间月余。（2）由于鼻胆管放置时间较短，胆汁的丢失明显减少，可防止大量的消化液，电触质及消化酶的损失（P＜0．01）不会引起电解质紊乱，消化不良，食欲减退(3)鼻胆管术后3－7d就可拔除，免除长期带T管给患者带来的痛苦。（4）减少术后并发症，特别是拔T管后的胆汗性腹膜炎。（5）节省住院费用，结论 胆总管切开取石后鼻胆管可以代替T管的作用，减少了T管引起的并发症。

NASOBILIARY DUCT IN ONE STAGE SUTURE AFTER CBD INCISION AND EXPLORATION

Objective To study the nasobiliary duct instead of T tube in one stage suture after CBD incision and exploration.Method Nasobiliary ducts were placed in 26 aged patients after ERCP,CBD was one stage sutured after incision and exploration.Results (1) Less time in hospital after operation.(2) Less loss of bile,digestive juice,electrolytes and digestive enzyme,no disturbance of electrolytes,dyspepsia or decreased food appetite.(3) no long term T tube distress because the nasobiliary duct is removed 3 to 7 days after operation.(4) Fewer postoperative complications,especially the biliary peritonitis after the removal of T tube. (5) less expense in hospital.Conclusions Nasobiliary duct may instead of T tube in one stage suture after CBD incision and explortion and release postoperative complications of T tube.