人纤维蛋白胶可减少胆总管结石患者腹腔镜胆总管探查术后一期缝合的术后胆漏。
Human fibrin sealant reduces post-operative bile leakage of primary closure after laparoscopic common bile duct exploration in patients with choledocholithiasis.
作者信息
Zhang Xu, Zhang Lei, Yu Yang, Sun Shibo, Sun Tiewei, Sun Yan
机构信息
Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
出版信息
J Minim Access Surg. 2019 Oct-Dec;15(4):320-324. doi: 10.4103/jmas.JMAS_129_18.
CONTEXT
Primary closure of the common bile duct (CBD) without drainage is considered a suitable approach after laparoscopic CBD exploration (LCBDE); however, the risk of post-operative bile leakage is high. Up to now, it has not been clear whether human fibrin sealant can reduce post-operative bile leakage of the primary suture.
AIMS
In this study, we evaluated the role of human fibrin sealant in primary closure of the CBD after LCBDE.
SUBJECTS AND METHODS
Patients with choledocholithiasis who had undergone primary duct closure of the CBD after LCBDE were divided into two groups according to whether fibrin sealant was used.
STATISTICAL ANALYSIS USED
Fisher's exact test or the Chi-square test was used for categorical variables to calculate frequencies and percentages between the groups. The Student's t-test was used to compare the means of the continuous variables between the groups.
RESULTS
The human fibrin sealant group had a lower rate of post-operative bile leakage compared to the other group (P < 0.05). There were no significant differences in additional parameters such as operative time, post-operative stay duration, time to drain removal, bile duct stenosis, acute allergic reaction and overall mortality.
CONCLUSIONS
Human fibrin sealant can reduce post-operative bile leakage in primary closure of CBD after LCBDE in patients with choledocholithiasis.
背景
在腹腔镜胆总管探查术(LCBDE)后,不进行引流直接对胆总管(CBD)进行一期缝合被认为是一种合适的方法;然而,术后胆漏的风险很高。到目前为止,人纤维蛋白胶是否能减少一期缝合后的术后胆漏尚不清楚。
目的
在本研究中,我们评估了人纤维蛋白胶在LCBDE后胆总管一期缝合中的作用。
研究对象与方法
将接受LCBDE后胆总管一期缝合的胆总管结石患者,根据是否使用纤维蛋白胶分为两组。
统计分析方法
采用Fisher精确检验或卡方检验对分类变量进行分析,以计算两组之间的频率和百分比。采用Student t检验比较两组连续变量的均值。
结果
与另一组相比,人纤维蛋白胶组术后胆漏发生率较低(P < 0.05)。在手术时间、术后住院时间、拔管时间、胆管狭窄、急性过敏反应和总死亡率等其他参数方面,两组之间无显著差异。
结论
人纤维蛋白胶可降低胆总管结石患者在LCBDE后胆总管一期缝合的术后胆漏发生率。
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