腹腔镜胆道探查前瞻性非随机对照研究

目的:探讨腹腔镜胆道手术后不放置T管(胆道)引流的可行性。方法:对2005年2月至2005年11月我院治疗的行腹腔镜胆总管探查的25例患者进行了前瞻性非随机对照研究。分为两组,观察组未放置T管,共15例;对照组放置T管,共10例。结果:患者均恢复良好。随访1~5月,观察组未发现结石复发或其它并发症,对照组1例残余结石,1例胆道下端狭窄,均经保守治疗后痊愈出院。两组结石残留率、近期并发症发生率、住院费用等方面差异无显著性(P>0.05),而在手术时间、住院时间等方面差异有显著性(P<0.05)。结论:腹腔镜胆道探查是较成熟的治疗胆总管结石的方法,根据术前影像学检查及术中胆道镜检查结果,决定是否放置T管引流。

Prospective and nonrandomized study of laparoscopic common bile duct exploration

Objective:To explore the feasibility of T tube free laparocopic common bile duct exploration(LCBDE).Methods:25 cases with common bile duct stones received LCBDE between February,2005 and November,2005.All patients were divided into T tube group and T tube free group according to results of ultrasound,ERCP,CT or MRCP.Results:LCBDE was performed successfully in all patients.The follow up ranged from 1 to 5 months.There was no complications such as recurrenc stone and bile leakage in T tube free group.Two complications were found in T tube group,one was residual stone and the other was bile duct stricture.There was no significant difference in complication rate and hospital cost in two groups(P>0.05).But there was significant difference in time of operation and hospitalization(P<0.05).Conclusions:LCBDE was matured technique in treatment of common bile duct stone.Placing T tube or not in LCBDE can be decided on the results of preoperative images and introperative findings.