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腹腔镜胆囊切除术联合与不联合腹部预防性引流。

Laparoscopic cholecystectomy with and without abdominal prophylactic drainage.

机构信息

Department of Surgery, Nakatsu Municipal Hospital, Nakatsu-City, Oita, Japan.

出版信息

Dig Endosc. 2011 Apr;23(2):153-6. doi: 10.1111/j.1443-1661.2010.01068.x. Epub 2010 Dec 13.

Abstract

AIM

As techniques in laparoscopic cholecystectomy (LC) have improved, the role of routine prophylactic abdominal drainage may be limited. A retrospective review was carried out of patients undergoing elective LC to evaluate the benefit of routine drainage in simple uncomplicated procedures.

METHODS

This study of 295 patients with cholecystolithiasis or gallbladder polyp included 145 patients who underwent LC with drainage and 150 patients who underwent LC without drainage between 2003 and 2007. Allocation to drain or not to drain was non-randomized and based on surgeon preference according to intraoperative findings. Patient characteristics, operative results, and postoperative outcomes were compared between the two groups with univariate analysis.

RESULTS

Time to first flatus and length of postoperative hospital stay in the LC without drainage group were shorter than in the LC with drainage group. There was no significant difference between the two groups with respect to postoperative complication rate. No complications were noted due to the lack of drain placement.

CONCLUSION

The use of drain after simple elective uncomplicated LC could safely be limited to appropriate patients as judged by the operating surgeon.

摘要

目的

随着腹腔镜胆囊切除术(LC)技术的提高,常规预防性腹部引流的作用可能受到限制。对接受择期 LC 的患者进行回顾性研究,以评估在简单且无并发症的手术中常规引流的益处。

方法

本研究纳入了 295 例胆囊结石或胆囊息肉患者,其中 145 例行 LC 加引流术,150 例行 LC 不加引流术,时间为 2003 年至 2007 年。引流或不引流的分组是非随机的,根据术中发现由外科医生的偏好决定。对两组患者的一般特征、手术结果和术后转归进行单因素分析。

结果

LC 无引流组患者首次排气时间和术后住院时间短于 LC 引流组。两组患者术后并发症发生率无显著差异。由于未放置引流管,未出现与引流相关的并发症。

结论

对于简单择期无并发症的 LC,术后引流可根据手术医生的判断,安全地限于适当的患者。

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