中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 6
Jun.  2016
Turn off MathJax
Article Contents

Clinical effect of primary duct closure and T-tube drainage after laparoscopic common bile duct exploration:a comparative analysis

DOI: 10.3969/j.issn.1001-5256.2016.06.026
  • Published Date: 2016-06-20
  • Objective To investigate the effect of primary duct closure and T- tube drainage after laparoscopic common bile duct exploration,as well as the criteria for clinical application of primary duct closure.Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who were treated in The First Hospital of Jilin University from July 2014 to July 2015,and 51 patients who met the inclusion criteria were enrolled.Among these patients,26 underwent primary closure of the common bile duct and 25 underwent T- tube drainage.The change in total bilirubin after surgery,time to recovery of gastrointestinal function,volume of peritoneal drainage at 1 day after surgery,time of removal of peritoneal drainage tube,complications,length of postoperative hospital stay,and total hospital fee were analyzed and compared between the two groups.The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results The length of postoperative hospital stay and total hospital fee showed significant differences between the two groups(t =- 7.067,P < 0.001;t =- 3.126,P = 0.003).One patient in each group experienced a complication and was cured after treatment.Conclusion On the basis of strict control of surgical indications,the primary closure of common bile duct after laparoscopic common bile duct exploration has the advantages of a short length of hospital stay,low hospital fee,and high quality of life,and is safe and feasible.Therefore,it holds promise for clinical application.

     

  • loading
  • [1] TOZATTI J,MELLO AL,FRAZON O.Predictor factors for choledocholithiasis[J].Arq Bras Cir Dig,2015,28(2):109-112.
    [2] WILLIAMS EJ,GREEN J,BECKKINGHAM I,et al.Guidelines on the management of common bile duct stones[J].Gut,2008,57(7):1004-1021.
    [3]AHMED I,PRADHAM C,BECKINGHAM IJ,et al.Is a T-tube necessary after common bile duct exploration?[J].World J Surg,2008,32(7):1485-1488.
    [4]YIN Z,XU K,SUN J,et al.Is the end of the T-tube draina-ge era in laparoscopic choledochotomy for common bile duct stones is coming?A systematic review and meta-analysis[J].Ann Surg,2013,257(1):54-66.
    [5]DONG ZT,WU GZ,LUO KL,et al.Primary closure after laparoscopic common bile duct exploration versus T-tube[J].J Surg Res,2014,189(2):249-254.
    [6]ABELLN MORCILLO I,QURASHI K,ABRISQUETA CARRIN J,et al.Laparoscopic common bile duct exploration.Lessons learned after200 cases[J].Cir Esp,2014,92(5):341-347.
    [7]HERRERO A,PHILIPPE C,GUILLON F,et al.Dose the surgeon’s experience influence the outcome of laparoscopic treatment of common bile duct stones?[J].Surg Endosc,2013,27(1):176-180.
    [8] HUA J,LIN S,QIAN D,et al.Primary closure and rate of bile leak following laparoscopic common bile duct exploration via choledochotomy[J].Dig Surg,2015,32(1):1-8.
    [9]ZHANG HW,LUO X,CAO J,et al.Safety evaluation of laparoscopic common bile duct exploration and lithotomy without placing drainage tube[J].Chin J Dig Surg,2014,13(9):691-693.(in Chinese)张红卫,罗旋,曹君,等.腹腔镜胆总管探查取石术后一期缝合不放置引流管的安全性[J].中华消化外科杂志,2014,13(9):691-693.
    [10]ZHANG ZM,YUAN HM,ZHANG YZ.Strategy of laparoscopy and choledochoscopy or duodenoscopy for the treatment of cholecystolithiasis combined with choledocholithiasis[J].Chin J Dig Surg,2015,14(4):280-283.(in Chinese)张宗明,苑海明,张羽中.双镜联合同期治疗胆囊结石合并胆总管结石的策略[J].中华消化外科杂志,2015,14(4):280-283.
    [11]XU JB,WANG ZM,GUO JS.Influencing factors for primary suture of biliary tract after laparoscopic common bile duct exploration[J].J Clin Med Literature,2015,2(5):897-900.(in Chinese)徐晋斌,王志敏,郭建昇.腹腔镜下胆总管探查术后胆道一期缝合的影响因素分析[J].临床医药文献杂志,2015,2(5):897-900.
    [12] CHEN CC,WU SD,TIAN Y,et al.Sphincter of Oddi-preserving and T-tube-freel paroscopic management of extrahepatic bile duct calculi[J].World J Surg,2011,35(10):2283-2289.
    [13]WANG RT,SHI HP,DAI YH,et al.Clinical application of choledocholithotomy with primary suture in treatment of choledocholithiasis[J].J Clin Exp Med,2014,13(23):1992-1995.(in Chinese)王瑞涛,史和平,代引海,等.胆总管切开取石一期缝合的临床应用[J].临床医学和实验学杂志,2014,13(23):1992-1995.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1952) PDF downloads(411) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return