经胆囊管细管引流测胆道压力对胆总管切开一期缝合的指导意义

发布时间：2018-03-01 14:03

本文关键词： 腹腔镜一期缝合胆道压力胆道测压　出处：《中国微创外科杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的通过经胆囊管细管引流测量术后不同时间患者的胆道压力,观察是否存在术后压力持续增高。方法 2013年1月~2014年6月对52例行腹腔镜胆囊切除,胆总管切开取石一期缝合术行胆道压力测定。采用经胆囊管留置细管进入胆道进行测压,通过中心静脉压的装置测量,分别测定术后第3、7、11天胆道压力。结果 3例术后第3天出现胆漏,第6天消失。所有患者顺利出院,无并发症。术后第3、7、11天胆道压力分别为(20.49±1.44)、(16.09±1.48)、(11.29±1.74)cm H2O,两两比较均有统计学差异(P均=0.000)。结论腹腔镜下胆囊切除,胆总管切开取石一期缝合术后胆道压力逐渐降低,胆漏最可能在术后3 d左右发生,术后第7、11天后胆漏的机会明显减少。一期缝合的病人出院时并不增加胆道压力,不增加出院后胆漏风险。
[Abstract]:Objective to measure the biliary tract pressure of patients with cholecystic duct drainage at different time after operation and to observe whether there is a continuous increase in postoperative pressure. Methods 52 patients underwent laparoscopic cholecystectomy from January 2013 to June 2014. Choledocholithotomy and primary suture were performed to measure the pressure of bile duct. Bile duct pressure was measured on the 3rd day, 7th day and 11th day after operation. Results the bile leakage occurred on the 3rd day after operation and disappeared on the sixth day. All the patients were discharged smoothly. There was no complication. The pressure of bile duct was 20.49 卤1.44 and 11.29 卤1.74 cm H _ 2O on the 3rd and 7th day after operation, respectively. Conclusion the pressure of bile duct gradually decreased after laparoscopic cholecystectomy and choledocholithotomy, after primary suture of choledocholithiasis, the pressure of bile duct was decreased gradually, and the pressure of bile duct decreased gradually after primary suture of choledocholithiasis, and the pressure of bile duct was decreased gradually after laparoscopic cholecystectomy and choledochotomy. Bile leakage was most likely to occur about 3 days after operation, and the chance of bile leakage was significantly reduced after 7 to 11 days after operation. The primary suture did not increase the biliary tract pressure at discharge, and did not increase the risk of bile leakage after discharge.
【作者单位】：吉林省前卫医院普外科;长春医学高等专科学校;
【基金】：吉林省卫计委科研立项(项目编号:7011S032)
【分类号】：R657.4

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