腹腔镜胆总管结石一期缝合和放置T管的临床应用

Clinical application of primary duct closure and T-tube drainage in laparoscopic choledocholithiasis

目的探讨腹腔镜胆总管结石一期缝合和放置T管的临床疗效。方法选取2014年01月至2017年10月安庆市第一人民医院普外科收治的57例胆总管结石患者为研究对象,依据手术方式分为观察组(一期缝合)23例,对照组(放置T管)34例,回顾性分析两组患者的所有临床资料。结果观察组住院时间、术后6 h疼痛视觉模拟评分(visual analogue scale,VAS)均低于对照组,差异有统计学意义(P<0.05),而手术时间、腹腔引流时间、术中出血量、术后并发症,两组差异无统计学意义(P>0.05)。结论腹腔镜胆总管切开取石术后施行一期缝合,严格把握适应证,同样安全、有效,并能充分体现微创治疗优势,值得临床推广。

Objective To investigate the clinical effect between primary duct closure and T-tube drainage in laparoscopic choledocholithiasis. Methods A number of 57 cases of choledocholithiasis patients were selected as the research object, and they were divided into the study group（ primary duct closure） （n = 23 ）and the control group（ T-tube drainage） （n = 34） , and retrospective analyzed their clinical data. Result The postoperative hospitalization time and VAS were lower in the study group than that in the control group（P 〈0. 05） ,but there were no significant difference between two groups in the operation time, peritoneal drainage time, intraop- erative bleeding volume and postoperative complications （P 〉 0.05）. Conclusion Primary duct closure after laparoscopic choledocholithotomy, under the premise of strictly grasping the surgical indications, is also a safe and effective way. It canfully demonstrate the advantages of minimally invasive surgery and is worthy of clinical promotion.