任贵兵 1毛中鹏 1吴凤云 1张瑞奎 1马熙 1王磊1
作者信息
- 1. 武警后勤学院附属医院肿瘤外科,天津300162
- 折叠
摘要
Abstract
Objective To study the treatment approach of biliary fistula after removal of T tube, in the process of laparoscopic choledocholithotomy with T tube drainage (LCTD). And, on the basis of clinical routine methods, to discuss the feasibility of fibrin glue to block T tube sinus orifice. Methods The research objects were collected for the LCTD postoperatively, biliary fistula found after the removal of T tube. Thirty-six cases were randomly divided into 2 groups. A control group of 18 cases, when bile leakage found after the removal of the T tube, food and water fasting, gastrointestinal decompression, acid and enzyme inhibition, anti infection treatments were carried out. At the same time, the endoscopic T tube sinus catheter was placed or endoscopic nasobiliary drainage undergone. The study group of 18 cases, when bile leakage found after the removal of the T tube, in addition to the routine methods carried out same as the control group, fibrin glue sealant was implanted through T tube sinus by choledochofiberscopy, to block the sinus laceration or the incomplete healing. Recovery conditions in patients of two groups were compared and statistically analyzed. Results In the control group, signs of peritonitis recovered more slowly, treatment processed for a longer time, and costs higher. Two patients underwent a second operation. In the study group, signs of peritonitis recovery more quickly, with shorter treatment time and lower cost, no second operation needed in all patients. Comparison between the two groups, each index had a significant difference (P <0.05). Conclusion For patients with bile leakage after the removal of the T tube, in addition to the routine methods of food and water fasting, gastrointestinal decompression, acid and enzyme inhibition, anti infection, endoscopic T tube sinus catheter placed or endoscopic nasobiliary drainage undergone, the implantation of fibrin glue sealant can improve the recovery speed, with lower cost, no second operation, which is worth popularizing.关键词
T管/胆漏/胆道镜/生物蛋白胶Key words
T tube/ biliary fistula/ biliary tract endoscope/ fibrin glue sealant分类
医药卫生
