Stoppa R, Henry X, Canarelli J, Verhaeghe P, Loquet P
J Chir (Paris). 1981 Oct;118(10):557-63.
The authors believe that utilisation of calibrating drainage is justified in case of difficult restauration of the C.B.D. of normal caliber, either throughout its length or in one segment. They underline that "axial exit" has not the disadvantages of the "lateral exit" of T-tubes. They recall the various modalities of "axial exit" (transcystic, transpapillary, transhepatic, "en seton") and their own contribution to the improvement of the transpapillary drainage by the association of a systematic sphincterotomy. Abstract of their clinical series, technics, postoperative mortality and morbidity, calibrating drainage duration and results (in connection with etiology) are reported. Main advantages of the "axial exit" are the absence of any risk of stenosis on a non dilated C.B.D. (as for the "lateral exit") and the facility for long time calibration up to several years. No hemorrhage, no bile leakage have been observed. The one only risk of this sort of drainage is the premature fall of transcystic or transpapillary drains ; but this disadvantage does not exist for "en seton" drainage. Shortly : "axial exit" calibrating drainage is recommandable when a very long time calibration after restauration of non dilated C.B.D. is necessary.
作者认为，在胆总管正常管径难以全程或某一段恢复时，使用校准引流是合理的。他们强调，“轴向引出”没有T形管“侧向引出”的缺点。他们回顾了“轴向引出”的各种方式（经胆囊、经乳头、经肝、“置入引流管”）以及他们自己通过系统性括约肌切开术联合应用对经乳头引流改善所做的贡献。报告了他们临床系列的摘要、技术、术后死亡率和发病率、校准引流持续时间及结果（与病因相关）。“轴向引出”的主要优点是在未扩张的胆总管上没有任何狭窄风险（如同“侧向引出”），并且便于长达数年的长期校准。未观察到出血和胆漏。这种引流唯一的风险是经胆囊或经乳头引流管过早脱落；但“置入引流管”引流不存在这一缺点。简而言之：当未扩张的胆总管恢复后需要非常长时间的校准时，“轴向引出”校准引流是值得推荐的。
