双镜联合胆总管探查取石术后胆总管一期缝合与T管引流的效果比较

Comparison of the Effects of Primary Suture of the Common Bile Duct and T Tube Drainage After Double Mirror Combined with Common Bile Duct Exploration and Stone Removal

目的比较双镜联合胆总管探查取石术后胆总管一期缝合与T管引流疗效。方法选取2019年6月-2020年6月在我院进行双镜联合胆总管探查取石术的患者,共94例。采用随机数字表法分为观察组和对照组,每组47例。对照组的患者术后进行T管引流,观察组术后进行胆总管一期缝合,比较两组手术指标、并发症发生情况、术后残石率以及治疗满意度。结果观察组手术时间、术中出血量、胃肠功能恢复时间、腹腔及T管引流管留置时间均少于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.38%,低于对照组的14.89%,差异有统计学意义(P<0.05);观察组术后残石率为8.51%,与对照组的10.63%比较,差异无统计学意义(P>0.05);观察组满意度为97.87%,高于对照组的87.23%,差异有统计学意义(P<0.05)。结论胆总管一期缝合与双镜联合胆总管探查取石术后T管引流比较,安全有效,可缩短手术时间,加快术后恢复,且可避免T管引流引起的并发症,充分体现微创理念的优势。

Objective To compare the efficacy of primary suture of the common bile duct and T tube drainage after double mirror combined with common bile duct exploration and stone removal.Methods A total of 94 patients who underwent double mirror combined common bile duct exploration and lithotripsy in our hospital from June 2019 to June 2020 were selected.Using random number table method,they were divided into observation group and control group,with 47 cases in each group.Patients in the control group received T-tube drainage after surgery,and the observation group received primary suture of the common bile duct after surgery.The surgical indicators,complications,postoperative residual stone rate and treatment satisfaction were compared between the two groups.Results The operation time,intraoperative blood loss,gastrointestinal function recovery time,abdominal cavity and T-tube drainage tube indwelling time in the observation group were less than those in the control group,the difference was statistically significant(P<0.05);The incidence of complications in the observation group was 6.38%,which was lower than 14.89%in the control group,the difference was statistically significant(P<0.05);The postoperative residual stone rate in the observation group was 8.51%,compared with 10.63%in the control group,the difference was not statistically significant(P>0.05);The satisfaction degree of the observation group was 97.87%,which was higher than 87.23%of the control group,the difference was statistically significant(P<0.05).Conclusion The primary suture of the common bile duct is safe and effective compared with T tube drainage after double mirror combined with common bile duct exploration and stone removal.It can shorten the operation time,speed up postoperative recovery,and avoid complications caused by T tube drainage,fully embodying the advantages of the minimally invasive concept.