胆道镜辅助下胆总管探查术后胆管一期缝合与置T型管引流的临床效果比较

王保全，张玮，姚建龙

（渭南市中心医院普外科，陕西 渭南，714000）

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摘要：

目的 比较胆道镜辅助下胆总管探查术后胆管一期缝合与置T 型管引流的效果。方法 选取我院2010 年1 月至2016 年 12 月收治的105 例胆总管结石或胆囊结石继发胆总管结石患者为研究对象，包含行胆总管探查一期缝合术患者54 例（一期 缝合组）和T 型管引流术患者51 例（T 管引流组）。观察并分析两种手术的效果。结果 一期缝合组的手术时间、术后通气时间 和住院时间均短于T 管引流组，差异均有统计学意义（P<0.05）。两组胆汁漏、胆管狭窄和胆管残余结石发生率比较差异不显 著（P>0.05）。结论 在掌握好适应证及手术操作要点的情况下，胆道镜辅助下胆总管探查术后胆管一期缝合安全有效，临床应 用可行。

关键词：胆道镜；胆总管结石；胆总管探查术；胆管一期缝合；T 型管引流

中图分类号：R657.4文献标志码：A文章编号：2096-1413(2018)03-0065-02

Clinical effect comparison of bile duct primary suture and T-tube drainage after exploration of common bile duct under choledochoscope
WANG Bao-quan, ZHANG Wei, YAO Jian-long
(General Surgery Department, Weinan Central Hospital, Weinan 714000, China)

ABSTRACT: Objective To compare the effect of bile duct primary suture and T -tube drainage after exploration of common bile duct under choledochoscope. Methods A total of 105 cases of choledocholithiasis or cholecystolithiasis secondary to choledocholithiasis in our hospital from January 2010 to December 2016 were selected as the study objects, including 54 cases of bile duct primary suture (primary suture group) and 51 cases of T-tube drainage (T-tube drainage group). The effects of two kinds of operations were observed and analyzed. Results The operation time, postoperative ventilation time and hospitalization time of the primary suture group were less than those of the T-tube drainage group, and the differences were statistically significant (P<0.05). There were no significant differences in the incidence of bile leakage, bile duct stricture and residual bile duct stones between the two group (P>0.05). Conclusion Under the condition of
mastering the indications and operation points, the bile duct primary suture under choledochoscope assisted bile duct exploration is safe and effective, and the clinical application is feasible.
KEYWORDS: choledochoscope; choledocholithiasis; exploration of common bile duct; bile duct primary suture; T-tube drainage

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