鼻胆管代T管在胆总管探查中的应用价值

The applied value of nasobiliary duct instead of T-tube in common bile duct exploration

目的探讨鼻胆管代替T管在胆总管探查及胆管一期缝合中的价值。方法比较两种手术方式内镜下鼻胆管引流(endoscopic nasobiliary drainage,ENBD)+胆总管探查(common bile duct exploration,CBDE)+胆管一期缝合(n=56)和常规CBDE+T管(n=42)的术前肝功能及术前、后相关并发症和住院时间。结果56例ENBD后行CBDE+胆管一期缝合术前肝功能明显改善(P<0.01),与常规CBDE+T管术前肝功能相比,差异有统计学意义(P<0.01);ENBD+CBDE+胆管一期缝合术后并发症明显减少(P<0.05),住院时间缩短(P<0.05)。结论鼻胆管可代替T管引流并能行胆道切口一期吻合,而且可改善患者术前肝功能,缩短住院时间,减少并发症的发生。

Objective To explore the applied value of nasobiliary duct instead of T-tube in one stage suture after common bile duct exploration （CBDE）. Methods Fifty-six cases of stone in common bile duct were chosen for one stage suture after endoscopic nasobiliary drainage （ENBD） and CBDE; and forty-two cases of stone in common bile duct were selected for routine CBDE and T-tube drainage. Liver function and complications and duration of hospital stay after operation in both groups were compared. Results Liver function of patients was improved after ENBD （P〈0.01）, difference was significant compared to routine CBDE and T-tube drainage （P〈0.01）. CBDE with ENBD instead of T-tube was obviously reduced postoperative complications and shortened duration of hospital stay for one stage suture. Conclusion ENBD nasobiliary duct may substitute for T-tube in one stage suture after CBDE and improve hypohepatia and reduced postoperative complications.