腹腔镜胆总管切开取石免T管引流可行性研究

Feasibility of laparoscopic common bile duct exploration without T-tube drainage

目的探讨腹腔镜胆总管切开取石免T管引流的可行性。方法 2014年5月至2015年8月我院接诊37例胆总管结石患者,其中行T管引流22例(T管组),免T管引流15例(免T管组)。观察2组患者手术时间、住院费用、肛门排气时间、术后住院时间、胆漏发生人数和调查患者术后满意度。结果免T管组肛门排气时间为(1.41±0.82)d、术后住院时间为(4.82±1.61)d,低于T管组的(3.81±1.09)d和(11.17±1.19)d,2组比较差异具有统计学意义(P<0.05);免T管组患者术后胆漏人数为0,低于T管组31.82%,2组差异具有统计学意义(P<0.05);免T管组患者满意度100%高于T管组50%,2组差异具有统计学意义(P<0.05)。结论腹腔镜胆管切开取石免T管引流具有良好的可行性,可在临床推广。

Objective To explore the feasibility of laparoscopic common bile duct exploration without T-tube drainage. Methods A total of 37 patients who were addmitted into our hospital from May 2014 to August 2015 with common bile duct stones were analyzed. Among these patients,22 cases were given T-tube drainage while the other 15 cases were not. The operation time,hospitalization expenses,anal exhaust time,postoperative hospitalization time,bile leakage rate and the satisfaction of patients after surgery in the two groups were observed.Results In the non-T-tube group,the anal exhaust time was（1. 41 ± 0. 82） d and the hospitalization time was（4. 82 ± 1. 61） d,which were lower than（ 3. 81 ± 1. 09） d and（ 11. 17 ± 1. 19） d respectively in the T-tube group,and the differences were statistically significant（P 0. 05）. The number of bile leakage（0%） in the non-T-tube group was also significantly lower than 31. 82% in the T-tube group（P 0. 05）. The satisfaction rate of patients in the non-T-tube group（100%） was significantly higher than that in T-tube group（50%）,and the difference was statistically significant（ P 0. 05）. Conclusion The laparoscopic common bile duct exploration without T-tube drainage is feasible and it can be popularized in clinic.