胆总管探查后内置鼻胆管与T管的比较研究

Comparative study of internal nasobiliary drainage and T-tube drainage after exploration of common bile duct

目的 探讨胆总管探查后内置鼻胆管 (BD管 )与T管对胆总管的影响。方法 选择同龄猪为实验对象 ,行胆总管探查后观察内置BD管与T管对胆总管的影响。结果 两种内置管使胆总管呈现不同程度扩张。管壁增厚 ,粘膜和肌层呈现不同程度炎性变 ,BD管较T管对胆总管刺激和损伤小。结论 BD管内置可起到与T管类似的引流和支架功能 ,使胆总管探查后成功地进行一期缝合 ,克服了T管引流的许多问题 ,符合微创观念。

Objective To evaluate the effects of internal nasobiliary drainage (BD) and T-tube drainage on the common bile duct. Methods A total of 10 swines of the same age were used. After exploration of the common bile duct, nasobiliary tube (n=6) and T-tube (n=4) were internally placed respectively. The effects of the internal tubes on the common bile duct were observed. Results Two kinds of internal tubes caused various degrees of dilation of the common bile duct. Thickened duct wall and various degrees of inflammatory changes in the mucous membrane and the muscular layer were found. BD had less stimulation and injury on the common bile duct as compared with T-tube. Conclusion BD may have the similar functions of drainage and bracket of T-tube and overcome many shortcomings of T-tube, which makes primary suture of the common bile duct safe and reliable after exploration of common bile duct.