一项比较内镜下胆管支架与T管在腹腔镜胆总管探查术后用于胆道减压的随机试验。
A randomized trial comparing the use of endobiliary stent and T-tube for biliary decompression after laparoscopic common bile duct exploration.
作者信息
Mangla Vivek, Chander Jagdish, Vindal Anubhav, Lal Pawanindra, Ramteke Vinod K
机构信息
Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Surg Laparosc Endosc Percutan Tech. 2012 Aug;22(4):345-8. doi: 10.1097/SLE.0b013e31825b297d.
PURPOSE
To compare the use of a biliary stent with T-tube for biliary decompression after laparoscopic common bile duct (CBD) exploration.
METHODS
Between September 2004 and March 2008, 60 patients undergoing laparoscopic CBD exploration for CBD stones were randomized to choledochotomy closure over either a biliary stent or a T-tube after CBD clearance. Patients at high risk for surgery and unremitting cholangitis requiring preoperative endoscopic biliary drainage were excluded.
RESULTS
There were 29 and 31 patients in the T-tube and stenting groups, respectively. The 2 groups were comparable with respect to their demographic profile and disease characteristics. Patients in the stent group had a significantly shorter operative time and postoperative stay with an earlier return to normal activity (P<0.0001).
CONCLUSIONS
Choledochotomy closure over a stent results in a shorter postoperative stay and an earlier return to normal activity compared with closure over a T-tube without any increase in morbidity.
目的
比较腹腔镜胆总管探查术后使用胆管支架与T管进行胆管减压的效果。
方法
2004年9月至2008年3月期间，60例因胆总管结石接受腹腔镜胆总管探查的患者在胆总管清理后，被随机分为两组，一组在胆总管切开术后通过胆管支架关闭胆总管，另一组则通过T管关闭胆总管。排除手术高危患者以及术前需要内镜胆管引流的持续性胆管炎患者。
结果
T管组和支架组分别有29例和31例患者。两组在人口统计学特征和疾病特点方面具有可比性。支架组患者的手术时间明显更短，术后住院时间更短，恢复正常活动更早（P<0.0001）。
结论
与使用T管关闭胆总管相比，使用胆管支架关闭胆总管可缩短术后住院时间，更早恢复正常活动，且不增加发病率。
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