肝胆胰外科杂志2024，Vol.36Issue(9)：540-544,5.DOI:10.11952/j.issn.1007-1954.2024.09.006
三镜联合免T管保留Oddi括约肌功能在胆总管结石治疗中的应用
Application of laparoscopy,choledochoscopy and duodenoscopy with T-tube free in the treatment of choledocholithiasis
摘要
Abstract
Objective To study the clinical effect of laparoscopy,choledochoscopy and duodenoscopy with T-tube free in the treatment of choledocholithiasis.Methods A retrospective analysis was conducted on the clinical data of choledocholithiasis patients,who underwent laparoscopic common bile duct exploration+endoscopic nasobiliary drainage+primary closure(LCBDE+ENBD+PC group,n=38)or laparoscopic common bile duct exploration+endoscopic T-tube drainage(LCBDE+T-tube group,n=49),in the First People's Hospital of Qujing between Sep.2021 and Sep.2023.The indexes of operation time,intraoperative bleeding,postoperative complications,hospitalization time and cost were compared between the two groups.Results Between the LCBDE+ENBD+PC group and LCBDE+T-tube group,there was no statistical difference in intraoperative bleeding[(46±10)mL vs(50±11)mL,t=-1.750,P=0.084],rate of one-time stone removal[94.74%(36/38)vs 93.88%(46/49),χ2=0.029,P=0.864],or time of abdominal drainage tube remove[(4.3±1.0)d vs(4.4±1.0)d,t=-0.879,P=0.382].The hospitalization time[(9.4±0.9)d vs(11.5±2.1)d,t=-8.456,P<0.001],total cost[(21750±966)yuan vs(22862±2 026)yuan,t=-3.177,P=0.002]and complication incidence rate in LCBDE+ENBD+PC group were significantly lower than those in the LCBDE+T-tube group[10.53%(4/38)vs 36.73%(18/49),χ2=7.781,P=0.005].Conclusion LCBDE+ENBD+PC treatment for choledocholithiasis can not only reduce the postoperative complication incidence rate,but also can shorten hospitalization time and total cost,avoid the pain with T-tube for a long time;LCBDE+ENBD+PC treatment can protect Oddi sphincter function,which provide a new way for the treatment of choledocholithiasis.关键词
胆总管结石/腹腔镜/胆道镜/十二指肠镜/鼻胆管引流/T管引流Key words
choledocholithiasis/laparoscopy/choledochoscopy/duodenoscopy/endoscopic nasobiliary drainage/T-tube drainage分类
医药卫生引用本文复制引用
刘振华,李月宏,刘培万,黎昭君,彭雄兵,方兴保..三镜联合免T管保留Oddi括约肌功能在胆总管结石治疗中的应用[J].肝胆胰外科杂志,2024,36(9):540-544,5.基金项目
云南省科技厅基础研究计划昆医联合专项重点项目(202301AY070001-019) （202301AY070001-019）
云南省科技厅基础研究计划昆医联合专项面上项目(202401AY070001-260) （202401AY070001-260）
兴滇英才支持计划项目 （）
曲靖市第一人民医院院级课题(2022YJKTZ01,2021YJKTY14). （2022YJKTZ01,2021YJKTY14）
