摘要
目的探讨经胆囊管纤维胆道镜胆总管探查的临床应用效果。方法我院2004年1月至2008年6月期间用该方法治疗胆囊结石合并胆总管结石患者28例(研究组);另选择同期行胆总管切开取石T管引流术患者30例(对照组),比较观察2组患者的手术和住院时间、输液量、住院费用、术后恢复情况、手术并发症等。结果研究组较对照组术后住院时间更短〔(6.0±1.1)d比(9.6±1.8)d,P<0.05〕,肛门排气时间〔(28.2±3.8)h比(46.3±5.9)h,P<0.05〕和恢复正常生活时间〔(10.3±2.1)d比(35.7±5.8)d,P<0.01〕更快,输液量〔(5 515±368)ml比(9 542±834)ml,P<0.01〕和住院费用〔(8 100±425)元比(12 100±756)元,P<0.05〕更少。研究组发生手术并发症2例(2/28);对照组发生手术并发症6例(6/30),其中需再次外科手术治疗的严重并发症2例(2/30),严重并发症均由放置T管引起。结论对于合适的胆囊结石合并胆总管结石的患者,可首选经胆囊管纤维胆道镜胆总管探查,避免了放置T管引起的一系列弊端,是安全、可行的。
Objective To evaluate the clinical results of choledochofiberscopic common bile duct （CBD） exploration through cystic duct. Methods Twenty-eight patients with cholecystolithiasis and CBD stones from January 2004 to June 2008 performed with transcystic CBD exploration were included as research group. Thirty patients through T-tube drainage were selected at the same time as control group. All the data were recorded and studied. Results Compared with the control group, research group had shorter postoperative hospital stay [（6.0±1.1） d vs. （9.6±1.8） d, P〈0. 051, time of passage of gas by anus [（28.2±3.8） h vs. （46.3±5.9） h, P〈0.05] and time of life return to normal after operation （（10.3±2.1） d vs. （35.7±5.8） d, P〈0.01], less average amount of postoperative transfusion [（5 515±368） ml vs. （9 542±834） ml, P〈0.01] and hospital costs [（8 100±425） yuan vs. （12 100±756） yuan, P〈0.05]. The incidence of postoperative complications was 2/28 in research group, which was 6/30 in control group, the incidence of severe complications that needed reoperation was 2/30, and all of them were caused by T-tube. Conclusion Transcystic CBD exploration through choledochoscope should be considered as the first choice in appropriate patients with both cholecystic and CBD stones, and it is feasible and safe, which can avoid the deficiency of T-tube drainage.
出处
《中国普外基础与临床杂志》
CAS
2009年第4期308-310,共3页
Chinese Journal of Bases and Clinics In General Surgery
关键词
经胆囊管
纤维胆道镜
胆总管探查
Through cystic duct
Choledochofiberscope
Common bile duct exploration
