胆道镜胆总管探查并一期缝合联合胆囊和肝叶切除在肝内外胆管结石患者中的应用效果

Application Effect of Cholangioscopic Common Bile Duct Exploration and Primary Suture Combined with Cholecystectomy and Hepatic Lobectomy in Patients with Intrahepatic and Extrahepatic Bile Duct Stones

目的:探讨胆道镜胆总管探查并一期缝合联合胆囊和肝叶切除在肝内外胆管结石患者中的应用效果。方法:选取2019年1月—2021年1月于黄冈市团风县人民医院行肝内外胆管结石手术的70例患者作为研究对象,随机分为试验组与对照组,各35例。两组均采用胆囊和肝叶切除、胆道切开胆道镜胆总管探查取石,试验组采用一期缝合,对照组留置T管引流。比较两组围术期相关指标及术后并发症发生情况。结果:两组术中出血量比较,差异无统计学意义(P>0.05);试验组手术时间、肛门排气时间、下床活动时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。试验组术后并发症发生率低于对照组,差异有统计学意义(P=0.024)。结论:胆道镜胆总管探查并一期缝合联合胆囊和肝叶切除在肝内外胆管结石患者中的应用效果显著,能够缩短手术时间,减少术中出血量,加速术后恢复进程,降低并发症发生率。

Objective:To investigate the application effect of cholangioscopic common bile duct exploration and primary suture combined with cholecystectomy and hepatic lobectomy in patients with intrahepatic and extrahepatic bile duct stones.Methods:A total of 70 patients undergoing intrahepatic and extrahepatic bile duct stone surgery in Huanggang Tuanfeng County People's Hospital from January 2019 to January 2021 were selected as the study subjects.They were randomly divided trial group and control group,with 35 cases in each group.Patients in both groups were treated with cholecystectomy,hepatic lobectomy,choledochotomy and cholangioscopic common bile duct exploration for stone extraction.The trial group received primary suture.The control group received T-tube drainage.Perioperative related indicators and postoperative complications were compared between the two groups.Results:There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).The operation time,anal exhaust time,ambulation time and length of hospital stay in the trial group were shorter than those in the control group,with statistically significant difference(P<0.05).The incidence of postoperative complications in the trial group was lower than that in the control group,and the difference was statistically significant(P=0.024).Conclusion:Cholangioscopic common bile duct exploration and primary suture combined with cholecystectomy and hepatic lobectomy has significant application effects in patients with intrahepatic and extrahepatic bile duct stones,it can shorten the operation time,reduce intraoperative blood loss,accelerate postoperative recovery and decrease the incidence of complications.