摘要
目的探讨T管单侧缝合固定法在腹腔镜胆总管探查(LCBDE)取石术中应用的安全性及有效性。方法回顾性分析2018年1月至2023年12月在河南省直第三人民医院行LCBDE联合T管引流术治疗的51例胆囊结石合并胆总管结石患者的临床资料。依据T管固定方法分为两组:A组为T管单侧缝合(T管置于胆总管切口头侧端,缝合胆总管切口尾侧端)固定组(n=30),B组为T管双侧缝合(T管置于胆总管切口中部,缝合胆总管切口头尾两侧端)固定组(n=21)。比较两组患者一般情况、围手术期肝功能和炎症指标、术中出血量、手术时间、总住院时间、总住院费用、术后T管相关并发症、术后1年内胆总管结石复发率等资料。结果两组患者一般资料具有可比性。经过治疗后,两组在围手术期炎症指标和肝功能指标水平、术中出血量、总住院时间、总住院费用、术后T管相关并发症发生率、术后1年内胆总管结石复发率方面比较,差异均无统计学意义(P>0.05);但在手术时间上的比较,A组明显短于B组[(152.33±32.79)min vs(183.57±38.86)min,t=−3.102,P=0.003]。结论T管单侧缝合固定的方法在LCBDE治疗胆总管结石中的应用是安全、有效的,可以降低手术总体难度,缩短手术时间,且不会增加术后T管相关并发症发生率。
Objective To investigate the safety and efficacy of the unilateral suture fixation of T-tube in laparoscopic common bile duct exploration(LCBDE).Methods The clinical data of 51 patients with cholecystolithiasis complicated by choledocholithiasis,who underwent LCBDE and the T-tube drainage in the Third People's Hospital of Henan Province from January 2018 to December 2023,were retrospectively analyzed.The patients were divided into two groups according to the T-tube fixation method,Group A received the unilateral suture fixation of T-tube(T-tube was placed at the cephalic end of the common bile duct incision,and the caudal end of the common bile duct incision was sutured)(n=30);Group B received the bilateral suture fixation of T-tube(T-tube was placed in the middle of the common bile duct incision,and both the cephalic and caudal ends of the common bile duct incision were sutured)(n=21).The general conditions of patients,intraoperative blood loss,total operation time,postoperative complications related to the T-tube,perioperative liver function and inflammatory indicators,total hospitalization time,total hospitalization cost,and common bile duct stone recurrence rate within 1 year after operation were compared between the two groups.Results The general data of the two groups were comparable.There were no statistically significant differences between the two groups in terms of intraoperative blood loss,total hospitalization time,total hospitalization cost,incidence of postoperative complications related to the T-tube,levels of perioperative liver function and inflammatory indicators,and common bile duct stone recurrence rate within 1 year after operation(P>0.05).The total operation time of Group A was significantly shorter than that of Group B[(152.33±32.79)min vs(183.57±38.86)min,t=-3.102,P=0.003].Conclusion The application of unilateral suture fixation of T-tube in LCBDE for common bile duct stones is safe and effective.It can reduce the overall difficulty of the operation,shorten the operation time,and does not increase the incidence of postoperative complications related to the T-tube.
作者
丁同领
程相超
张家明
宋伍侠
DING Tongling;CHENG Xiangchao;ZHANG Jiaming;SONG Wuxia(Department of General Surgery,the Third People’s Hospital of Henan Province,Zhengzhou,Henan 450000,China)
出处
《肝胆胰外科杂志》
2026年第1期39-43,48,共6页
Journal of Hepatopancreatobiliary Surgery
关键词
胆囊结石
胆总管结石
腹腔镜手术
胆总管探查术
单侧缝合固定
T管引流
cholecystolithiasis
choledocholithiasis
laparoscopy
common bile duct exploration
unilateral suture fixation
T-tube drainage
