[1]李少明,汤万荣,李 薇,等.双镜联合胆道内支架置入、胆总管一期缝合技术临床应用*[J].陕西医学杂志,2019,(1):13-15.
　LI Shaoming,TANG Wanrong,LI Wei,et al.Clinical application of double endoscopic combined with percutaneous transhepatic insertion of biliary stents and one stage suture technique of common bile duct[J].,2019,(1):13-15.
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双镜联合胆道内支架置入、胆总管一期缝合技术临床应用*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年1期
页码:
13-15
栏目:
临床研究
出版日期:
2019-01-05

文章信息/Info

Title:
Clinical application of double endoscopic combined with percutaneous transhepatic insertion of biliary stents and one stage suture technique of common bile duct
文章编号:
DOI:10.3969/j.issn.10007377.2019.01.004
作者:
李少明; 汤万荣; 李 薇; 杨荣彬
广东省江门市中心医院肝胆外科（江门529000）
Author(s):
LI Shaoming; TANG Wanrong; LI Wei; et al.
Department of Hepatobiliary Surgery ,Jiangmen Central Hospital in Guangdong Province(Jiangmen 529000)
关键词:
胆总管结石;  腹腔镜; 胆道镜; 胆总管一期缝合技术; 胆道内支架置入; 外科学
Keywords:
Key words Common bile dact stones; Laparoscopic; Choledochoscopic; One stage suture technique of common bile duct; Percutaneous transhepatic insertion of biliary stents; Choledocholithiasis; Surgery〖HK〗〖HT〗〖HJ1〗〖HJ〗
分类号:
R657.4
文献标志码:
A
摘要:
摘 要 目的：探讨双镜联合胆道内支架置入、胆总管一期缝合技术对胆总管结石的疗效。方法：选取腹腔镜胆总管结石手术患者共125 例，根据术中引流方式不同，分为两组，观察组36 例行腹腔镜胆总管切开、胆道镜探查取石、胆道内支架置入、胆总管一期缝合术，对照组89例行腹腔镜胆总管切开、胆道镜探查取石、Ｔ 管引流术，对手术相关指标进行观察。结果：观察组在手术时间、住院天数、拔管时间等明显少于对照组，而在术后并发症方面，观察组术后胆漏发生率明显低于对照组(P＜0.05)。结论：双镜联合胆道内支架置入、胆总管一期缝合技术应用于治疗胆总管结石是可行的，能有效降低术后并发症发生率，缩短住院时间，具有临床价值。
Abstract:
Abstract Objective:To investigate the efficacy of double endoscopic combined with percutaneous transhepatic insertion of biliary stents and one stage suture technique of common bile duct.Methods:125 cases of laparoscopic choledocholithiasis were selected .According to the different drainage methods,the patients were divided into two groups.In the observation group,36 cases were treated by laparoscopic choledochotomy,choledochoscopy,percutaneous transhepatic insertion of biliary stents and one stage suture technique of common bile duct,and 89 cases in the control group with tube incision,choledochoscopy,drainage and T tube drainage,observed the operative parameters.Results:The operation time,the number of days of hospitalization and the time of extubation of the observation group were significantly less than those in the control group,and the postoperative complication rate of the observation group was significantly lower than that of the control group(P＜0.05).Conclusion:It is feasible to treat choledocholithiasis with double endoscopic combined with percutaneous transhepatic insertion of biliary stents and one stage suture technique of common bile duct,it can effectively reduce the incidence of postoperative complications and shorten the time of hospitalization,which has the value of clinical promotion.

参考文献/References:

[1] 廖均平,梁日光,梁永任,等.经肝穿刺与经十二指肠镜途径胆道支架置入治疗恶性胆道梗阻性黄疸的对照研究[J].河北医学,2017,23(10):16021605. [2] 温顺前,谢学弈,巫 青,等.腹腔镜下胆总管探查取石术后胆总管一期缝合的疗效分析[J].中国普通外科杂志,2018,27(2):163168. [3] 杜 强,张福庆,纪 刚,等.经皮肝穿刺胆道支架置入治疗恶性胆道梗阻疗效及安全性分析[J].第三军医大学学报,2015,37(6):578581. [4] 李 炜,张计训,杨佳华,等.内镜下胆道塑料支架置入引流术治疗复发性胆总管结石合并乳头旁憩室[J].肝胆胰外科杂志,2015,27(6):490493. [5] 屠政斌,袁建毛.经胆囊管汇入部微切开与胆总管一期缝合在腹腔镜胆总管探查术中的应用比较[J].肝胆胰外科杂志,2015,27(5):402405. [6] 王国泰,杨兴武,王 旗,等.腹腔镜自行脱落J管胆道引流、胆总管一期缝合治疗肝外胆管结石的疗效分析[J].中华肝胆外科杂志,2017,23(10):669673. [7] 路夷平,叶晋生,姚 力,等.腹腔镜胆总管探查顺行鼻胆管引流胆总管一期缝合的临床应用[J].中华普通外科杂志,2016,31(11):893896. [8] 张引涛,余兆惠,邓 睿,等.三镜联合治疗肝胆管结石53例[J].陕西医学杂志,2015，44(1):122123. [9] 翁 杰,秦启翻,黄小龙,等.肝叶切除配合胆道镜探查胆总管一期缝合治疗肝内外胆管结石25例[J].海南医学,2017,28(24):40764078.〖ZK）〗 [10] 刘学礼,吴卫国,张玉豹,等.胆总管一期缝合治疗胆总管结石疗效及术后胆漏危险因素分析[J].肝胆胰外科杂志,2017,29(3):196199,202. [11] 谷化剑,雷绍奎,喻 超,等.腹腔镜胆道探查胆总管一期缝合术治疗胆管结石的疗效分析[J].腹部外科,2017,30(4):291294. [12] 管辉球,景 岚,徐锁青,等.胆总管一期缝合经胆囊管胆管引流与鼻胆管引流的对比研究[J].中华外科杂志,2018,56(2):130134.

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备注/Memo

备注/Memo:
*广东省江门市医疗卫生领域科技计划项目（20150020002677）
更新日期/Last Update: 2019-01-22