选择性胆总管探查切口一期缝合的临床对照研究

A clinical comparison study of selective primary suture after choledochotomy

目的探讨选择性胆总管探查切口一期缝合的临床适应证和可行性。方法根据术前检查和术中胆管探查结果进行筛选，符合入组条件者随机分组行T管引流或一期缝合术，对其治疗结果进行对照。结果符合入组条件者共161例，其中一期缝合组85例和T管引流组76例。所有患者均无严重并发症及远期并发症发生。一期缝合组术后平均住院时间（8．5±3．2）d，与T管组（16．3±6．5）d相比，有显著性差异。结论在严格掌握适应证的前提下，胆总管探查切口采用一期缝合是可行的，较之传统留置T管的方法有一定优势。

Objective To discussi the feasibility and indication of selective primary suture after choledochotomy. Methods The selected patients were intra-operatively randomized to have either primary suture or T tube drainage after choledochotomy. Comparison of the clinical effects in different groups was done. Results Totally 161 cases were randomized into two groups： the primary sutures group 85 cases and the T tube drainage group 76 cases. All patient had no serious or long-term complications. The average hospital stay in primary suture group was significantly shorter （ 8.5± 3.2 ） d than T-tube group（ 16.3 ± 6.5 ） d. Conclusion Under strict indications, the primary suture after choledochotomy is feasible, and has advantages compared with the traditional method.