自制胆道内引流管在腹腔镜胆总管手术中的应用

目的:探讨自制胆道内引流管在腹腔镜胆总管探查(LCBDE)并一期缝合术中的应用价值。方法:选择2013年1月—2014年6月收治的63例胆总管结石患者,其中25例应用自制胆道内引流管行LCBDE一期缝合并内引流术(自制内引流管组),38例行LCBDE并常规T形管引流术(常规T形管引流组),比较两组的相关临床指标。结果:与常规T形管引流组比较,自制内引流管组手术时间与术中出血量差异无统计学意义(均P0.05);自制内引流管组术后离床时间、术后住院时间、住院费用均明显减少(均P0.05),但胃肠功能恢复时间无统计学差异(P0.05)。内引流管术后随粪便排出的时间为(11.2±2.6)d,1例(4.0%)未能顺利排管,后于胃镜下取出。结论:LCBDE一期缝合自制引流管内引流在胆总管结石治疗上有传统术式不具备的优势。

Application of self-designed internal biliary drainage tube in laparoscopic common bile duct exploration

Objective: To investigate the applicable value of self-designed internal biliary drainage tube in laparoscopic common bile duct exploration (LCBDE) with primary closure. Methods: Sixty-three patients with common bile duct stones admitted during January 2013 to June 2014 were selected. Of the patients, 25 cases underwent LCBDE with primary closure and internal drainage using self-designed biliary internal drainage tube (self-designed internal drainage tube group), and 38 cases underwent LCBDE plus conventional T-tube drainage (conventional T-tube drainage group). The relevant clinical variables between the two groups were compared. Results: In self-designed internal drainage tube group compared with conventional T-tube drainage group, the operative time and intraoperative blood loss showed no significant difference (both P>0.05); the time to postoperative ambulation, length of postoperative stay and hospitalization expenses were all significantly decreased (all P<0.05), but the time for recovery of bowel function had no significant difference (P>0.05). Time for the internal drainage tube to be discharged during defecation after operation was (11.2±2.6) d, and in one case (4.0%) the tube failed to be discharged during defecation, and it was then removed by endoscopy. Conclusion: In dealing with common bile duct stones, LCBDE with primary closure and internal drainage using self-designed biliary internal drainage tube has advantages over the traditional procedure.