临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (1): 37-.

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三镜联合经腹置入鼻胆管引流术在肝外胆管结石中的应用效果

  

  1. 江门市新会区第二人民医院 普外科,广东 江门 529000
  • 出版日期:2023-01-01 发布日期:2023-03-07
  • 基金资助:

    江门市科技计划项目(2021YL08047)

The effect of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones

  1. General Surgery Department of The Second People's Hospital of Xinhui District of Jiangmen City, Guangdong Jiangmen 529000, China
  • Online:2023-01-01 Published:2023-03-07

摘要:

目的 探讨三镜联合经腹置入鼻胆管引流术在肝外胆管结石中的疗效。方法 回顾性分析江门市新会区第二人民医院2021 年3 月至2022 年8 月收治的胆总管结石患者80 例,随机数字表法分成观察组与对照组各40 例。两组患者均进行腹腔镜下胆囊切除术、胆道探查、经腹鼻胆管引流、一期缝合,观察组进行经腹顺行安置鼻胆管,对照组患者经口置入鼻胆管引流,比较两组患者的手术时间、术中出血量、是否需要行十二指肠乳头切开、置管时间、置管成功率和术后首次排气时间、腹腔引流管拔除时间、鼻胆管拔除时间、住院天数、并发症等。结果 观察组患者的手术时间长于对照组,十二指肠乳头切开率显著低于对照组患者(P < 0.05),两组患者术中出血量无显著差异(P > 0.05)。观察组患者的置管时间、胃肠恢复排气时间、腹腔引流管拔除时间以及鼻胆管拔出时间都短于对照组(P < 0.05),但两组患者的置管成功率以及住院天数无显著差异(P > 0.05)。观察组患者的并发症发生率显著低于对照组患者(P < 0.05)。结论 使用三镜联合经腹置入鼻胆管引流术在肝外胆管结石中的疗效较好,安全性高。

关键词: 鼻胆管引流, 肝外胆管结石, 疗效

Abstract:

Objective To investigate the effect of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones. Method 80 patients with choledocholithiasis admitted to the Second People's Hospital of Xinhui District of Jiangmen City from March 2021 to August 2022 were retrospective analysis and randomly divided into observation group and control group with 40 cases each. Both groups of patients underwent laparoscopic cholecystectomy, bile duct exploration, transabdominal nasobiliary duct drainage, and primary suture. The observation group underwent antegrade placement of nasobiliary duct through the abdomen, and the control group underwent oral placement of nasobiliary duct drainage. The general

information, preoperative bilirubin, diameter of common bile duct, number of common bile duct stones, and other systemic diseases were compared between the two groups. The operation time, intraoperative blood loss, whether duodenal papillectomy was needed, catheterization time, catheterization success rate, postoperative intestinal recovery and exhaust time, abdominal drainage tube removal time, nasobiliary tube removal time, hospital stay and complications were compared between the two groups, and statistical analysis was performed. Result The operation time of patients in the observation group was longer than that in the control group, and the incision rate of duodenal papilla was significantly lower than that in the control group (P < 0.05), there was no significant difference in intraoperative bleeding between the two groups (P > 0.05). The intubation time, gastrointestinal recovery time, extraction time of abdominal drainage tube and nasobiliary duct in the observation group were shorter than those in the control group (P < 0.05), however, there was no significant difference between the two groups in the success rate of intubation and the length of stay (P > 0.05). The incidence of complications in the observation group was

significantly lower than that in the control group (P < 0.05). Conclusion The application of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones is effective and high security.

Key words: Nasobiliary drainage, Extrahepatic bile duct stones, The curative effect