胆道镜辅助下胆总管探查术后胆管一期缝合与置T型管引流的临床效果比较

Clinical effect comparison of bile duct primary suture and T-tube drainage after exploration of common bile duct under choledochoscope

目的比较胆道镜辅助下胆总管探查术后胆管一期缝合与置T型管引流的效果。方法选取我院2010年1月至2016年12月收治的105例胆总管结石或胆囊结石继发胆总管结石患者为研究对象,包含行胆总管探查一期缝合术患者54例(一期缝合组)和T型管引流术患者51例(T管引流组)。观察并分析两种手术的效果。结果一期缝合组的手术时间、术后通气时间和住院时间均短于T管引流组,差异均有统计学意义(P<0.05)。两组胆汁漏、胆管狭窄和胆管残余结石发生率比较差异不显著(P>0.05)。结论在掌握好适应证及手术操作要点的情况下,胆道镜辅助下胆总管探查术后胆管一期缝合安全有效,临床应用可行。

Objective To compare the effect of bile duct primary suture and T-tube drainage after exploration of common bile duct under choledochoscope. Methods A total of 105 cases of choledocholithiasis or cholecystolithiasis secondary to choledocholithiasis in our hospital from January 2010 to December 2016 were selected as the study objects,including 54 cases of bile duct primary suture（primary suture group） and 51 cases of T-tube drainage（T-tube drainage group）. The effects of two kinds of operations were observed and analyzed. Results The operation time, postoperative ventilation time and hospitalization time of the primary suture group were less than those of the T-tube drainage group, and the differences were statistically significant（P〈0.05）. There were no significant differences in the incidence of bile leakage,bile duct stricture and residual bile duct stones between the two group（P〉0.05）. Conclusion Under the condition of mastering the indications and operation points, the bile duct primary suture under choledochoscope assisted bile duct exploration is safe and effective, and the clinical application is feasible.