腹腔镜胆总管探查术后不留置T管引流的临床研究.docVIP

精品论文 参考文献 腹腔镜胆总管探查术后不留置T管引流的临床研究 （安岳县第三人民医院 四川资阳 642350） 　　【摘要】目的：研究腹腔镜胆总管探查术（LCBDE）后不留置T管引流的临床效果。方法：回顾分析我院2014年3月-2016年3月接受腹腔镜胆总管探查术的136例胆总管结石患者的临床资料。结果：136例行腹腔镜胆总管探查术的患者中，成功132例，有4例取石失败，其中3例行术中内镜下乳头括约肌切开术并同期取石，1例中转开腹。132例中有100行腹腔镜胆总管探查术后不留置T管引流，其中经胆囊管胆总管探查37例，平均手术时间（2.4plusmn;0.3）h，手术后平均住院时间（3.8plusmn;1.3）d；胆囊切除胆总管切开探查取石术后胆总管一期缝合63例，平均手术时间（2.2plusmn;0.5）h，手术后平均住院时间（3.5plusmn;1.1）d；132例腹腔镜胆总管探查术中胆总管切开探查T管引流32例，平均手术时间（2.5plusmn;1.6）h，手术后平均住院时间（3.4plusmn;1.5）d。平均于术后（35plusmn;3.2）d后行T管拔管术。其中2例于拔管术后出现腹痛，后通过镇痛等保守治疗，痊愈出院；1例于拔管术后5d内并发胆瘘，经保持腹腔引流5—12 d 痊愈；1例胆道残留结石，行内镜下乳头括约肌切开术取石成功。后期平均随访（15.2plusmn;7.5）月，未出现胆道狭窄。136例患者中未见死亡病例。结论：在条件允许的病例中，可以行腹腔镜胆总管探查术后不留置T管引流，从而大大缩短住院时间，并且降低T管引流所来的各种并发症。 　　【关键词】胆总管探查术；腹腔镜；结石；T管引流 　　【中图分类号】R619 【文献标识码】A 【文章编号】1007-8231（2016）20-0036-02 　　 After laparoscopic common bile duct exploration not lien T tube drainage of clinical research 　　 Shi Pingfu.Sichuan anyue county the third peoples hospital from 642350 　　【Abstract】Objective To study the laparoscopic common bile duct exploration (LCBDE) is not retained after the clinical effect of T tube drainage. Methods Retrospective analysis of our hospital in March 2014 -March 2016 underwent laparoscopic common bile duct exploration of the clinical data of 136 patients with common bile duct calculi. Results Of 136 patients who underwent laparoscopic common bile duct surgical exploration, successfully in 132 cases, there are 4 cases of rock failure, 3 of whom underwent intraoperative endoscopic sphincterotomy and nipple removed during this period, 1 case of transfer laparotomy. 132 lines in 132 cases of laparoscopic common bile duct exploration is not retained after T tube drainage, including via the cystic duct 37 cases of common bile duct exploration, the average operation time (2.4plusmn;0.3) h, after the operation, the average length of hospital stay (3.8plusmn;1.3) d; Gallbladder excision of common bile duct incision exploratory postoperative bile duct litho