目的 探讨单J管内引流在胆总管探查术后一期缝合中的作用。
方法 回顾性分析2008年－2013年34例因胆管结石或胆总管增粗行胆总管探查后放置单J管内引流并一期缝合的患者的临床资料。
结果 患者均顺利完成手术，术后7～10 d出院，平均8.7 d；随访1～4年，平均2.9年。单J管均于术后10～25 d（平均20.2 d）随粪便排出；仅1例患者于术后1年出现胆管炎，余无并发症发生。
结论 胆总管探查术后放置单J管内引流可有效防止术后因胆总管末端水肿所致的胆漏等并发症，术式简单安全，值得推广。
Citation：
蒋耀昌. 单J管内引流在胆总管一期缝合术中的应用. West China Medical Journal, 2015, 30(3): 499-501. doi: 10.7507/1002-0179.20150141
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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Wills VL, Gibson K, Karihaloo C, et al. Complications of biliary T-tubes after choledochotomy[J]. ANZ J Surg, 2002, 72(3):177-180.
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黄志强. 胆道外科手术学[M]. 2版. 北京:人民军医出版社出版, 2010:64-65.
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Decker G, Borie F, Millat B, et al. One hundred laparoscopic choledochotomies with primary closure of the common bile duct[J]. Surg Endosc, 2003, 17(1):12-18.
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Lygidakis NJ. Choledochotomy for biliary lithiasis:T-tube drainage or primary closure. Effects on postoperative bacteremia and T-tube bile infection[J]. Am J Surg, 1983, 146(2):254-256.
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张光全, 吴先麟, 廖忠, 等. 胆总管一期缝合术(附350例报告)[J]. 肝胆胰外科杂志, 2008, 20(6):420-422.
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Seale AK, Ledet WJ. Primary common bile duct closure[J]. Arch Surg, 1999, 134(1):22-24.
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Sheen-Chen SM, Chou FF. Choledochotomy for biliary lithiasis:is routine T-tube drainage necessary? A prospective controlled trial[J]. Acta Chir Scand, 1990, 156(5):387-390.
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钱礼. 腹部外科学[M]. 2版. 上海:上海科学技术出版社, 1984:864.
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禹正杨, 何生, 李静, 等. 胆总管切开探查术后一期缝合胆管的评价(附6个随机对照临床试验的meta分析)[J]. 中国实用外科杂志, 2003, 23(1):41-43.
|
- 1. Wills VL, Gibson K, Karihaloo C, et al. Complications of biliary T-tubes after choledochotomy[J]. ANZ J Surg, 2002, 72(3):177-180.
- 2. 黄志强. 胆道外科手术学[M]. 2版. 北京:人民军医出版社出版, 2010:64-65.
- 3. Ahmed I, Pradhan 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. Decker G, Borie F, Millat B, et al. One hundred laparoscopic choledochotomies with primary closure of the common bile duct[J]. Surg Endosc, 2003, 17(1):12-18.
- 5. Lygidakis NJ. Choledochotomy for biliary lithiasis:T-tube drainage or primary closure. Effects on postoperative bacteremia and T-tube bile infection[J]. Am J Surg, 1983, 146(2):254-256.
- 6. 张光全, 吴先麟, 廖忠, 等. 胆总管一期缝合术(附350例报告)[J]. 肝胆胰外科杂志, 2008, 20(6):420-422.
- 7. Seale AK, Ledet WJ. Primary common bile duct closure[J]. Arch Surg, 1999, 134(1):22-24.
- 8. Sheen-Chen SM, Chou FF. Choledochotomy for biliary lithiasis:is routine T-tube drainage necessary? A prospective controlled trial[J]. Acta Chir Scand, 1990, 156(5):387-390.
- 9. 钱礼. 腹部外科学[M]. 2版. 上海:上海科学技术出版社, 1984:864.
- 10. 禹正杨, 何生, 李静, 等. 胆总管切开探查术后一期缝合胆管的评价(附6个随机对照临床试验的meta分析)[J]. 中国实用外科杂志, 2003, 23(1):41-43.
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