肝胆胰外科杂志2025，Vol.37Issue(4)：254-258,5.DOI:10.11952/j.issn.1007-1954.2025.04.007
一期胆管缝合术和胆管内置T管引流术在腹腔镜胆总管探查术后的效果比较
Comparison of the effects between primary duct closure and T-tube drainage in laparoscopic common bile duct exploration
摘要
Abstract
Objective To compare the clinical efficacy and economic benefits of primary duct closure(PDC)versus T-tube drainage(TTD)in laparoscopic common bile duct exploration(LCBDE),to provide evidence-based guidance for clinical decision-making regarding surgical approaches.Methods A retrospective analysis was conducted on clinical data from 117 patients with common bile duct stones,who underwent LCBDE in Wenzhou People's Hospital between Jul.2022 and Jun.2024.Patients were divided into the PDC group(n=66)and the TTD group(n=51).The operation-related indicators,postoperative laboratory indicators,and postoperative recovery and complication incidence rates were compared between the two groups.Results(1)Surgery-related indicators:The operation time in the PDC group was significantly shorter than that in the TTD group,the intraoperative blood loss and the number of drainage tubes were less than those in the TTD group,with statistically significant differences(P<0.05);(2)Postoperative laboratory indicators:The white blood cell counts in the PDC group and the TTD group were 6.3(5.5,8.3)×109/L and 11.2(3.7,35.7)×109/L,respectively,and the C-reactive protein levels were 9.2(7.2,10.8)mg/L and 33.3(13.1,66.5)mg/L respectively,there were statistically significant differences between the two groups(P<0.05).The total bilirubin level in the PDC group was 15.5(10.2,24.8)μmol/L,which was lower than that in the TTD group 18.9(12.4,37.2)μmol/L,with a statistically significant difference(P<0.05);(3)Postoperative recovery and complication incidence rates:The abdominal drainage time,first food intake time,hospital stay and hospitalization expense in the PDC group were all less than those in the TTD group(P<0.05).The incidence of postoperative fluid collection in the surgical area was 24.24%(16/66)in the PDC group,which was significantly lower than that in the TTD group[50.98%(26/51)],with a statistically significant difference(P<0.05).There was no statistically significant difference in the incidence of postoperative bile leakage between the two groups(P>0.05).Conclusion Under the reasonable grasp of indications,the PDC surgical procedure has good safety and effectiveness,and is superior to the TTD surgical procedure in terms of surgical efficiency,postoperative recovery and economic benefits,which is in line with the concept of enhanced recovery after surgery.关键词
胆总管结石/腹腔镜手术/胆总管探查术/T管引流术/一期缝合术Key words
common bile duct stones/laparoscopy/common bile duct exploration/T-tube drainage/primary duct closure分类
临床医学引用本文复制引用
汪栩好,孙跃胜,汪文寰,徐晓敏,胡逸人..一期胆管缝合术和胆管内置T管引流术在腹腔镜胆总管探查术后的效果比较[J].肝胆胰外科杂志,2025,37(4):254-258,5.基金项目
温州市基础性公益科研项目(Y2023443). （Y2023443）
