带蒂大网膜人工窦道预防T管拔除后胆漏的临床意义

目的:探讨带蒂大网膜人工窦道成形术在预防T管拔除后胆漏发生中的手术方法及临床价值。方法:回顾性分析2005年12月-2014年8月我院收治的胆管探查、T管引流术357例。按术中应用带蒂大网膜人工窦道成形术及常规手术病例分为两组,手术后2-3周拔出T管,同时观察有无胆漏发生。结果:两组在术后T管拔除致胆漏发生率比较有显著性差异,施行带蒂大网膜人工窦道成形术组明显优于常规手术组。结论:在胆管探查,T管引流病人中应用带蒂大网膜人工窦道成形术可有效减少T管带管时间,降低术后拔管胆漏发生率,有很好的临床应用价值。

Clinical Significance of Man-Made Sinus with Pedicled Greater Omentum to Prevent Bile Fistula After Removal of T-tube

Objective:To investigate the surgical method and clinical value of man-made sinus with pedicled greater omentum in prevention of bile fistula after removal of T-tube.Methods:From Decemher 2005 to August 2014,357 patients with common bile duct exploration and T-tube drainage were analyzed retrospectively.Man-made sinus with pedicled greater omentum or conventional surgery were carried out intraoperatively.T tube was removed 2-3 weeks after the surgery,and then the presence of bile leakage was observed.Results:Compared with conventional surgery,the incidence of bile fistula of man-made sinus with pedicled greater omentum is obviously lower,which has significant difference.Conclusion:Man-made sinus with pedicled greater omentum can reduce the T-tube indwelling time effectively,as well as the incidence of bile leakage after removal of T-tube,which has great clinical application value.