腹腔镜下经胆囊管胆总管探查术与胆总管探查并一期缝合术治疗胆总管结石的对比研究

发布时间：2018-03-06 21:23

本文选题：胆总管结石病　切入点：腹腔镜　出处：《中国普通外科杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的:比较腹腔镜下经胆囊管胆总管探查术(LTCBDE)与经胆总管探查(LCBDE)+胆道一期缝合术治疗胆总管结石的效果。方法:回顾性分析2013年1月—2015年12月期间应用微创手术治疗的104例胆总管结石的患者临床资料,其中50例行LTCBDE(LTCBDE组)与54例行LCBDE+胆道一期缝合术(LCBDE+一期缝合组),比较两组的相关临床指标。结果:与LCBDE+一期缝合组比较,LTCBDE组手术时间(91.7 min vs.110.9 min)、术中出血量(15.5 mL vs.17.4 mL)、术后引流量(28.4 mL vs.44.6 mL)、带管时间(7.8 d vs.9.7 d)、住院时间(8.8d vs.10.6d)均明显减少(均P0.05);LTCBDE组术后胆汁漏的发生率明显低于LCBDE+一期缝合组(2.0%vs.13.0%,P=0.036),其他并发症的发生率两组无统计学差异(均P0.05)。结论:LTCBDE治疗胆总管结石安全可靠的,且较LCBDE+胆道一期缝合术更符合微创的目的,在两种术式的适应证均满足的情况下,可优先考虑。
[Abstract]:Objective: to compare the effect of laparoscopic transhepatic choledochus exploration (LTCBDE) and transhepatic choledocholithotomy (LCBDE) in the treatment of choledocholithiasis. Methods: from January 2013 to December 2015, minimally invasive surgery was performed on choledocholithiasis. Clinical data of 104 patients with choledocholithiasis, Among them, 50 cases (LTCBDE(LTCBDE group) and 54 cases LCBDE biliary tract primary suture group (LCBDE primary suture group) were compared with the two groups. Results: compared with the LCBDE primary suture group, the operation time was 91.7 min vs.110.9 min, and the intraoperative bleeding volume was 15.5 mL vs.17.4 mL. The postoperative drainage volume was 28.4 mL vs.44.6 mL / mL, the time with tube was 7.8 d / d / d, and the hospitalization time was 8.8 d vs 10.6 d). The incidence of postoperative bile leakage was significantly lower in the group of postoperative bile leakage than that in the group of primary suture of LCBDE (P < 0.01). There was no significant difference in the incidence of other complications between the two groups (P < 0.05). Conclusion it is safe and reliable to treat choledocholithiasis with 1% LTCBDE. Compared with LCBDE primary suture of biliary tract, it is more suitable for minimally invasive purpose. If the indications of both methods are satisfied, priority should be given to them.
【作者单位】：江苏大学医学院;江苏大学附属宜兴医院普通外科;
【分类号】：R657.42

【相似文献】