肝外胆管结石取石术后一期缝合与置T管引流的疗效分析

目的探讨肝外胆管结石取石后胆管一期缝合术的安全性。方法选择我院2007年1月～2012年1月因肝外胆管结石行胆总管切开取石术患者111例,其中行胆总管一期缝合50例（缝合组）,行T管引流61例（引流组）,对两组的临床疗效进行比较分析。结果两组患者在手术时间、腹腔引流时间、术后胆漏、结石残留和结石复发等方面差异均无统计学意义（均P〉0.05）;缝合组在住院时间、补液量、电解质紊乱发生率等项均少于引流组,差异均有高度统计学意义（均P〈0.01）。结论肝外胆管结石行胆总管取石后一期缝合,能明显缩短住院时间、减轻患者经济负担,而且不存在T管引起的各种弊端,只要掌握适应症该术式是可靠、安全的治疗方法。

Efficacy analysis of direct suture of bile duct and T-tube drainage in choledocholithotomy in the treatment of extrahepatic bile duct stones

Objective To explore the security of the direct suture of bile duct in the treatment of extrahepatic bile duct stones.Methods 111 patients with extrahepatic bile duct stones in choledocholithotomy surgery were selected from January 2007 to January 2012 in our hospital,50 patients were treated with primary suture（suture group）,61 patients were treated with T-tube drainage（drainage group）.The clinical efficacy of the two groups were analyzed retrospectively.Results The differences of operation time,abdominal drainage time,bile leakage,stone residues and stone recurrence in the two groups were not statistically significant（P 0.05）;The hospital stays,fluid volume and electrolyte imbalance were all found lower in suture group than those in drainage group,the differences were all statistically significant（P 0.01）.Conclusion The direct suture of bile duct in the treatment of extrahepatic bile duct stones can make the hospital stays become shorter,reduce the financial burden of patients,and do not cause the disadvantages of the T-tube drainage.The direct suture of bile duct in the treatment of extrahepatic bile duct stones is reliable and safe with proper indications.