内引流术治疗胆总管结石(附112例疗效分析)

Comparison of Treatment for Choledocholith in Common Bile Duct by Biliary-enterostomy and T Duct Drainage Operation

目的 探讨首次手术治疗胆总管结石即行内引流术的可行性和疗效。方法 选择胆总管直径 >1 2cm的胆总管结石患者 1 2 2例 ,随机分为内引流术组 (治疗组 ) 6 0例和T型管引流术组 (对照组 ) 6 2例 ,进行前瞻性对比分析。结果 内引流术组出现近期并发症 1 0例 ,远期并发反流性胆管炎 6例 ,再发结石 2例 ,均在局麻下行胆管镜取石及对症治疗而痊愈。T型管引流术组近期并发症 1 0例 ,远期并发胆管炎 1 2例 ,再发结石 9例 ;1 3例行 2次手术 ,改行内引流术 1 0例 ,3例因病重而再行T管引流 ,死亡 2例。结论 对胆总管管径 >1 2cm的胆总管结石首次即行内引流术 ,临床疗效良好。

Objective To evaluate the effects of treatment for choledocholith. Methods A retrospective analysis of comparisons and healing of 122 choledocholith patient from January 1991 to October 2001 was studied. Results Patients of choledocholith were successfully treated in 96.67% percent of biliary-enterostomy and its incidence rate of complications (8.16%) was significantly lower than that of T duct drainage operation. Conclusion Biliary-enterostomy for choledocholith could get the similar results of T duct drainage operation and more safety.