摘要
目的探讨术前置鼻胆管引流在腹腔镜胆总管探查一期缝合代替传统T管引流术的可行性。方法回顾性分析因胆总管结石行腹腔镜胆总管探查术72例的临床资料,比较术前置鼻胆管引流、胆总管一期缝合32例(鼻胆管组)与T管引流40例(T管组)的临床效果。结果两组均成功完成手术,术后无胆瘘发生,鼻胆管组拔管时间(6.3±1.6)d,术后住院时间(8.2±1.7)d,肛门排气时间(20.5±5.6)h,均较T管组的拔管时间(49.6±6.3)d,术后住院时间(13.3±3.6)d,肛门排气时间(28.8±6.3)h明显缩短,差异有显著性(P<0.01);手术时间及术后并发症两组比较,差异无显著性(P>0.05)。结论术前置鼻胆管引流、胆总管一期缝合术既能避免一期缝合后胆管压力增高引起的胆瘘,又能彻底消除T管引起的并发症,缩短住院天数,减轻患者的痛苦,值得推广。
【Objective】To research the clinical value of preoperative insertion of nasobiliary tube for after laparoscopic exploration of common bile duct （LCBD） and replacement of T-tube drainage with primary suture of （BD）. 【Methods】A retrospective analysis of clinical data of 72 cases of laparoscopic common bile duct exploration due to choledocholithiasis was conducted. The clinical effects of 32 cases of preoperative insertion of nasobiliary tube and primary suture of common bile duct （Nasobiliary group） were compared with 40 cases of T-tube drainage （T-tube group）. 【Results】Both of the groups successfully completed operation without postoperative bile leakage. The extubation time of nasobiliary group was （6.3±1.6） d. The postoperative hospitalization （8.2±1.7） d, time to pass flatus （20.5±5.6） h, which were all shorter than those of T-tube group （49.6±6.3） d, （13.3±3.6） d and （28.8±6.3） h respectively, with significant differences between the 2 groups （P 0.01）. There were no sighificant differences in operation time and complications （P 0.05）. 【Conclusions】Preoperative insertion of nasobiliary tube and primary suture of common bile duct can prevent not only bile leakage caused by increased biliary pressure after primary suture, but also completely eliminates complications caused by T-tube, and can shortens hospital stay. It is worth widespread application.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第10期1034-1037,共4页
China Journal of Endoscopy
关键词
腹腔镜
鼻胆管引流
胆总管切开术
胆瘘
laparoscopes
nasobiliary drainage
choledochostomy
biliary fistula
