腹腔镜胆总管探查治疗胆总管结石胆管闭合方式的选取比较

Comparison of laparoscopic choledocholithiasis in the treatment of choledocholithiasis

目的探讨和比较腹腔镜胆总管探查治疗胆总管结石胆管闭合方式的选取。方法回顾性分析2015年1月至2020年6月收治并予以腹腔镜胆总管探查治疗胆总管结石的患者80例,其中40例患者予以传统的胆总管T管引流(T管组),40例患者予以胆总管一期缝合(缝合组)。采用SPSS 21.0统计分析软件进行分析,两组患者围术期指标等计量资料以(x±s)表示,采用独立样本t检验;两组患者结石残留、结石复发等并发症发生率采用χ^(2)检验。P<0.05为差异具有统计学意义。结果缝合组患者手术时间、胆总管缝合时间、术后疼痛评分、术后镇痛药使用次数、排气时间、肠道功能恢复时间和住院时间均小于T管组,差异有统计学意义(P<0.05);两组患者术后胆道出血、胆瘘、胆道感染、胆道狭窄、结石残留、结石复发等并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜胆总管探查治疗胆总管结石采用一期缝合具有良好的治疗效果,且不增加患者治疗后并发症发生率。

Objective To explore and compare the selection of closure methods in the treatment of common bile duct stones.Methods 80 patients treated by laparoscopic common bile duct exploration were retrospectively analyzed from January 2015 to June 2020.including 40 patients who received traditional T-tube drainage(T-tube group),and 40 patients were treated with primary suture(primary suture group).SPSS 21.0 statistical analysis software was used for analysis.Perioperative indicators and other measurement data of the two groups were expressed by and independent sample t test was used;the incidence of complications such as residual stones and stone recurrence were analyzed byχ^(2) test.P<0.05 was considered statistically significant.Results The operation time,common bile duct suture time,postoperative pain score,the number of postoperative analgesic needle use,exhaust time,intestinal function recovery time and hospitalization time in the primary suture group were less than those in the T-tube group,and the difference was statistically significant(P<0.05);the amount of intraoperative bleeding,postoperative biliary bleeding,bile leakage,biliary tract infection,biliary stricture,residual stones,stone recurrence,etc.in the two groups There was no significant difference in the incidence of complications(P>0.05).Conclusion Laparoscopic common bile duct exploration in the treatment of choledocholithiasis with one-stage suture has a good therapeutic effect,and does not increase the incidence of postoperative complications.