摘要
目的 探讨腹腔镜下经胆囊管胆总管取石及胆总管切开取石治疗胆总管结石的可行性及临床疗效。方法 回顾性分析于2018年1月至2021年1月期间在南京医科大学附属淮安市第一医院治疗的胆囊结石合并胆总管结石患者的术前肝功能、胆道情况、手术指标、术后恢复情况、围手术期并发症及术后结石残留、胆总管形态变化情况等。将经胆囊管探查取石(LTCBDE)的患者设为实验组,胆总管切开取石(LCBDE)的患者设为对照组。结果 (1)两组术前肝功能指标、胆总管结石数量及最大结石直径、胆总管直径数据差异均无统计学意义。(2)实验组平均手术时间、留置引流管时间、住院时间、住院费用均低于对照组,且两组数据差异有统计学意义。两组禁食时间、腹腔引流量数据差异无统计学意义。(3)两组围手术期并发症发生率及术后胆总管结石残留率无统计学意义;实验组术后胆总管形态变化差异率低于对照组,且两组数据差异有统计学意义。结论 LTCBDE所需手术时间短、治疗费用低、对胆总管损伤小,具有较高的临床应用价值。
Objective To investigate the feasibility and clinical effect of choledocholithotomy via cystic duct and lithotomy after laparoscopic choledochotomy. Methods The preoperative liver function, biliary tract condition, surgical indicators, postoperative recovery, perioperative complications, the probability of finding stones in the common bile duct and the probability of stenosis caused by changes in the compliance of the common bile duct were reviewed in patients with Gallstones Complicated with common bile duct stones treated in Huai’an first people’s Hospital from January 2018 to January 2021. The patients with cystic duct exploration and lithotomy(LTCBDE) were set as the experimental group and the patients with common bile duct incision and lithotomy(LCBDE) were set as the control group.Results(1)There was no significant statistical differencein liver function, number of common bile duct stones, maximum stone diameter and common bile duct diameter at admission in the two groups.(2)The operation time, drainage tube removal time, the length of stay and hospitalization expenses were lower than those in the control group, and the data difference between the two groups was statistically significant. There was no significant difference between the two groups in the time of starting fluid diet and the flow of abdominal drainage tube.(3)There was no statistical significance in the probability of complications during hospitalization and the probability of finding common bile duct stones after operation. In the experimental group, the index of bile duct morphological change is lower than that of the pair array, and the difference between the two groups has obvious statistical significance. Conclusion Transcystic choledocholithotomy needs short operation time, reduces the economic pressure of patients, and has little damage to the common bile duct, which is conducive to maintaining the integrity of the common bile duct and has high clinical application value.
作者
洪晟乾
祁付珍
严雨楼
金铨
徐建波
禹亚彬
HONG Sheng-qian;QI Fu-zhen;YAN Yu-lou(Department of hepatobiliary surgery,the Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University,Huaian 223300,China)
出处
《肝胆外科杂志》
2022年第3期204-208,共5页
Journal of Hepatobiliary Surgery
关键词
胆总管结石
胆道镜
胆囊管
T管引流
laparoscope
choledocholithiasis
cystic duct
T tube drainage
