临床肝胆病杂志2018，Vol.34Issue(3)：526-530,5.DOI:10.3969/j.issn.1001-5256.2018.03.015
腹腔镜联合胆道镜胆总管探查一期缝合术洽疗胆囊结石合并胆总管结石的临床效果分析
Clinical effect of primary duct closure in laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration among patients with gallstones complicated by common bile duct stones
摘要
Abstract
Objective To investigate the clinical effect and safety of primary duct closure(PDC)in laparoscopic cholecystectomy(LC) combined with laparoscopic common bile duct exploration(LCBDE). Methods A retrospective analysis was performed for 76 patients with gallstones complicated by common bile duct stones who were admitted to Department of Hepatobiliary and Pancreatic Surgery in The First Af-filiated Hospital of Hainan Medical University from July 2015 to July 2017,and among these patients,20 underwent LC+LCBDE+PDC (PDC group)and 56 underwent LC+LCBDE+T-tube drainage(TTD)(TTD group). The two groups were observed and compared in terms of time of operation,intraoperative blood loss,time to gastrointestinal functional recovery after surgery,time to extraction of abdominal drainage tube,length of postoperative hospital stay,and incidence rates of related complications(residual common bile duct stones,biliary fistula,and biliary tract infection). The patients were followed up for 2-12 months after surgery. The t-test was used for comparison of continuous data between groups;the chi-square test was used for comparison of categorical data between groups. Results All patients un-derwent a successful laparoscopic surgery,and no patient was converted to open surgery. There were significant differences between the PDC group and the TTD group in time of operation(106.2 ± 15.8 min vs 147.5 ± 23.2 min,t= -2.87,P=0.036),time to gastrointestinal functional recovery after surgery(32.9 ± 8.1 h vs 49.4 ± 6.5 h,t= -3.61,P=0.021),time to extraction of abdominal drainage tube (3.5 ± 1.3 d vs 5.7 ± 2.6 d,t= -2.64,P=0.034),and length of postoperative hospital stay(6.3 ± 1.5 d vs 11.4 ± 2.0 d,t= -26.34, P<0.001). There were no significant differences between the two groups in intraoperative blood loss,postoperative biliary fistula,residual bile duct stones,and biliary tract infection(all P>0.05). Conclusion A preliminary study of limited cases in our hospital shows that if patients are suitable,PDC is safe and effective in LC and LCBDE.关键词
胆结石/腹腔镜检查/引流术Key words
cholelithiasis/laparoscopy/drainage分类
医药卫生引用本文复制引用
杨彦,林师佈,韩霖,黄小龙,涂伟..腹腔镜联合胆道镜胆总管探查一期缝合术洽疗胆囊结石合并胆总管结石的临床效果分析[J].临床肝胆病杂志,2018,34(3):526-530,5.基金项目
海南省自然科学基金面上项目(20168299) （20168299）
