腹腔镜下胆总管探查术后一期缝合与T管引流的回顾性对照研究

目的 探讨胆囊结石合并胆总管结石患者行腹腔镜下胆总管探查术后一期缝合与T管引流的疗效。方法 选取新疆医科大学第五附属医院2019年1月至2022年5月因胆囊结石合并胆总管结石行手术治疗的患者84例，根据手术方式不同将其分为一期缝合组（n=21）与T管引流组（n=63）。比较两组患者的围手术期指标、手术前后肝功能、术后并发症发生率及住院总费用。结果 一期缝合组患者的手术时间、术后胃肠道恢复时间、术后住院时间均显著短于T管引流组，住院总费用显著低于T管引流组（P<0.05）。两组患者的手术前后总胆红素、间接胆红素、直接胆红素、谷丙转氨酶、谷草转氨酶、碱性磷酸酶和术中出血量、术后并发症发生率比较差异均无统计学意义（P>0.05)。结论 胆囊结石合并胆总管结石患者在腹腔镜下胆总管探查取石后行一期缝合可缩短手术时间和术后住院时间，降低住院总费用，且患者舒适度较高，值得临床推广应用。

A retrospective comparative study of primary suture and T-tube drainage after laparoscopic common bile duct exploration

Objective To investigate the effect of primary suture and T-tube drainage after laparoscopic common bile duct exploration in patients with cholecystolithiasis combined with choledocholithiasis. Methods Eighty-four patients who underwent surgical treatment for cholecystolithiasis combined with choledocholithiasis in the Fifth Affiliated Hospital of Xinjiang Medical University from January 2019 to May 2022 were selected and divided into primary suture group (n=21) and T-tube drainage group (n=63) according to different surgical methods. The perioperative indexes, liver function before and after operation, incidence of postoperative complications and total hospitalization costs were compared between the two groups. Results The operation time, postoperative gastrointestinal recovery time and postoperative hospital stay in primary suture group were significantly shorter than those in T-tube drainage group, and the total hospitalization cost was significantly lower than that in T-tube drainage group (P<0.05). There were no significant differences in total bilirubin, indirect bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, intraoperative blood loss and postoperative complication incidence between the two groups (P>0.05). Conclusion In patients with cholecystolithiasis complicated with choledocholithiasis, primary suture after laparoscopic common bile duct exploration can shorten the operation time and postoperative hospital stay, reduce the total hospitalization cost, and the comfort level of patients is higher, which is worthy of clinical promotion and application.