Lygidakis N J
Am J Surg. 1983 May;145(5):636-9. doi: 10.1016/0002-9610(83)90111-3.
To assess the value of choledochoduodenostomy versus T-tube drainage to manage patients with recurrent choledocholithiasis, a prospective, randomized study was carried out where under strict criteria of selection, 45 patients underwent choledochoduodenostomy after choledochotomy (Group A), and another 45 patients underwent T-tube drainage (Group B). Results revealed that patients in Group A had low early morbidity (8.8 percent), no mortality, and no reoperations due to recurrent choledocholithiasis. In contrast, in Group B patients there was a mortality of 4.4 percent, an early morbidity of 26.6 percent, and a late recurrence and reoperation rate of 20.9 percent. The difference in those elements between patients in Group A and Group B is considered significant (p less than 0.05, p less than 0.001, and p less than 0.0001, mortality and early and late morbidity, respectively). It is recommended that at least for a proportion of patients with recurrent choledocholithiasis who present with clinical and operative findings similar to those in this study, choledochoduodenostomy has to be considered the method of choice.
为评估胆总管十二指肠吻合术与T管引流术治疗复发性胆总管结石患者的价值，开展了一项前瞻性随机研究，在严格的入选标准下，45例患者在胆总管切开术后接受了胆总管十二指肠吻合术（A组），另有45例患者接受了T管引流术（B组）。结果显示，A组患者早期发病率低（8.8%），无死亡病例，且无因复发性胆总管结石而再次手术的情况。相比之下，B组患者死亡率为4.4%，早期发病率为26.6%，晚期复发和再次手术率为20.9%。A组和B组患者在这些指标上的差异被认为具有显著性（死亡率、早期和晚期发病率分别为p<0.05、p<0.001和p<0.0001）。建议至少对于一部分具有与本研究相似临床和手术表现的复发性胆总管结石患者，胆总管十二指肠吻合术应被视为首选方法。
