置入鼻胆管行引流治疗后经腹腔镜治疗有胆道手术史的胆总管结石患者再行胆总管一期缝合术的安全性及可行性分析

doi:10.3969/j.issn.1006-6233.2018.07.023

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摘要 目的: 研究分析针对接受置入鼻胆管引流术后运用腹腔镜治疗的有胆道手术史的胆总管结石患者实施胆总管一期缝合术的效果。 方法: 将本院2014年2月至2016年2月期间共计收治的62例于胆胰外科治疗的有胆道手术史的胆总管结石患者。根据其治疗方式随机平均分成对照组和观察组,各31例。对照组给予常规腹腔镜下胆总管探查,接受T管引流,观察组则是在腹腔镜下置入鼻胆管引流,实施腹腔镜胆总管一期缝合术。分析两组患者手术情况及术后效果差异。 结果: 观察组患者的白细胞为(12.86±1.86)×10⁹L^-1,显著低于对照组(13.95±1.86)×10⁹L^-1,P<0.05;带管时间为(5.21±0.28)d,显著低于对照组(32.07±0.54)d,P<0.05;住院时长为(9.71±1.51)d,显著低于对照组(19.32±4.54)d,P<0.05;手术时长为(187.86±13.79)min,低于对照组(181.65±15.49)min,P>0.05;总胆红素为(37.04±13.72)μmoL/L,低于对照组(45.79±32.94)μmoL/L,P>0.05。术后并发症情况方面两组患者差异无统计学意义(P>0.05)。 结论: 针对接受置入鼻胆管引流术后运用腹腔镜治疗的存在胆道手术史的胆总管结石患者运用胆总管一期缝合术具有良好的可操作性,并且安全性高。

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	李得福

关键词 ：鼻胆管引流, T管引流, 胆道手术史, 腹腔镜, 胆总管一期缝合术

Abstract：Objective: To analyze the effect of primary suture of common bile duct in patients with choledocholithiasis with history of choledocholithiasis treated by laparoscopy after nasobiliary drainage. Methods: From February 2014 to February 2016, 62 cases of choledocholithiasis with history of choledocholithiasis treated by cholangiopancreatic surgery were divided into two groups: control group and observation. Group, 31 cases in each group. The control group and Eisou routine laparoscopic choledochus examination, T tube drainage, the observation group is under laparoscopic nasobiliary drainage. Laparoscopic choledochus primary suture was performed. Results: The white blood cells in the observation group were (12.86±1.86)×10⁹L^-1, which were significantly lower than those in the control group (13.95±1.86)×10⁹L^-1, P<0.05; The tube time was (5.21±0.28) d, which was significantly lower than that of the control group (32.07±0.54) d, P<0.05; The length of hospital stay was (9.71 ±1.51) d, which was significantly lower than that of the control group (19.32±4.54) d, P<0.05; The length of the operation was (187.86±13.79) min, which was lower than that of the control group (181.65±15.49) min, P>0.05; The total bilirubin was (37.04±13.72) mol/L, lower than that of the control group (45.79±32.94) mol/L, P>0.05. There was no significant difference in postoperative complications between the two groups (P>0.05). Conclusion: Choledocholithiasis with the history of choledocholithiasis with the history of choledochal surgery in the treatment of biliary tract surgery after naso biliary drainage is of good maneuverability and high safety.

Key words： Nasobiliary drainage T tube drainage Biliary tract operation history Laparoscope Primary suture of common bile duct

基金资助:青海省自然科学基金项目,( 编号:2013-Z-938Q)

引用本文:

李得福. 置入鼻胆管行引流治疗后经腹腔镜治疗有胆道手术史的胆总管结石患者再行胆总管一期缝合术的安全性及可行性分析[J]. 河北医学, 2018, 24(7): 1148-1151.
LI Defu. Safety and Feasibility of Laparoscopic Common Bile Duct Suture for Patients with Choledocholithiasis with History of Biliary Tract Surgery after Endoscopic Drainage. HeBei Med, 2018, 24(7): 1148-1151.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.07.023 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I7/1148