腹腔镜胆总管探查后一期胆管缝合治疗胆总管结石的效果观察

Observation of effect of laparoscopic common bile duct exploration after a suture choledocholithiasis

目的分析腹腔镜胆总管探查后一期胆管缝合治疗胆总管结石的临床效果。方法将100例胆总管结石患者的随机分为观察组与对照组,每组50例患者。观察组患者采取腹腔镜胆总管切开探查术后胆管一期缝合,对照组患者采取腹腔镜胆总管切开探查术后T管引流。对比分析两组患者的临床疗效。结果观察组患者与对照组患者在手术时间、手术中出血量及术后并发症的发生率等差异无统计学意义(P>0.05);观察组患者的肛门排气时间及术后住院时间均低于对照组患者,差异有统计学意义(P<0.05)。结论临床上应严格把握腹腔镜胆总管切开探查术后胆管一期缝合的适应证,在满足一期缝合的条件时,腹腔镜胆总管切开探查术后胆管一期缝合的引流疗效优于腹腔镜胆总管切开探查术后T管引流。

Objective To investigate and analyze the clinical results of laparoscopic common bile duct exploration after a suture cho-ledocholithiasis.Methods The clinical data of 100 cases with common bile duct stones who underwent laparoscopic common bile duct explo-ration in our hospital from January 2011 to January 2013 were retrospectively analyzed.Patients were divided into observation group and con-trol group in chronological order,with 50 cases in each group.The patients in the observation group took laparoscopic common bile duct explo-ration bile duct a suture,while those in control group received laparoscopic common bile duct exploration postoperative T-tube drainage.The clinical efficacy of the two groups of patients was comparatively analyzed.Results There was no statistically significant difference in the op-erative time,blood loss and the incidence of postoperative complications in patients of the observation group and the control group(P >0.05);however the difference in anal exhaust time,hospital costs and length of hospital stay after surgery in the observation group was statisti-cally significant compared with those in the control group(P <0.05).Conclusion In the clinical practice the indications of postoperative biliary a suture after laparoscopic common bile duct exploration should be strictly grasped.When the conditions of a suture are met,laparo-scopic common bile duct exploration postoperative biliary drainage of a suture can achieve better efficacy than laparoscopic common bile duct exploration postoperative T-tube drainage.