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find Keyword "T管引流" 8 results
  • Primary Suture versus T-tube Drainage after Laparoscopic Common Bile Duct Stone Exploration: A Systematic Review

    Objective To assess the benefits and harms of routine primary suture (LBEPS) versus T-tube drainage (LCHTD) following laparoscopic common bile duct stone exploration. Methods The randomized controlled trials (RCTs) or quasi-RCTs were electronically searched from the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2010), PubMed (1978 to 2010), EMbase (1966 to 2010), CBMdisc (1978 to 2010), and CNKI (1979 to 2010); and the relevant published and unpublished data and their references were also searched by hand. The data were extracted and the quality was evaluated by two reviewers independently, and the RevMan 5.0 software was used for data analysis. Results Four studies including 3 RCTs and 1 quasi-RCT involving 274 patients were included. The meta-analysis showed that compared with LCHTD, LBEPS was better in shortening operation time (WMD= –17.11, 95%CI –25.86 to –8.36), abdominal drainage time (WMD= –0.74, 95%CI –1.39 to –0.10) and post-operative hospitalization time (WMD= –3.30, 95%CI –3.67 to –2.92), in lowering hospital expenses (WMD= –2 998.75, 95%CI –4 396.24 to –1 601.26) and in reducing the complications due to T-tube such as tube detaching, bile leakage after tube drawing, and choleperitonitis (RR=0.56, 95%CI 0.29 to 1.09). Conclusion LBEPS is superior to LCHTD in total effectiveness for common bile duct stone with the precondition of strictly abiding by operation indication. Due to the low quality of the included studies which decreases the reliability of this conclusion, more reasonably-designed and strictly-performed multi-centered RCTs with large scale and longer follow up time are required to further assess and verify the efficacy and safety of this treatment.

    Release date:2016-09-07 11:01 Export PDF Favorites Scan
  • Analysis of Surgical Treatment of Acute Obstructive Jaundice Caused by Biliary Gallstone

    目的:探讨胆总管结石致急性梗阻性黄疸手术治疗的效果。方法:回顾分析72例手术治疗胆总管结石致急性梗阻性黄疸患者的临床资料。结果:术后死亡3例。随访3~6年,效果优良者62例。3例胆总管T管引流术后3年复发肝胆管结石。结论:对该病的治疗术前应尽量做全面辅助检查,明确结石的部位及大小,胆管的形态及位置。根据病情确定手术时机和方式,对保证患者安全,减少术后并发症,提高治愈率有重要意义。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • Primary Closure Versus T-Tube Drainage after Laparoscopic Exploration of Common Bile Duct

    目的 比较腹腔镜胆道探查术后胆总管一期缝合与T管引流两种术式治疗胆囊结石合并胆管结石的疗效。方法 回顾性分析2011年4月至2012年5月期间笔者所在科室收治的因胆囊结石合并胆管结石接受腹腔镜胆囊切除+胆道探查治疗的109例患者的临床资料,其中58例行T管引流,51例行一期胆总管缝合。比较2组患者的手术时间、住院时间、治疗费用、术后恢复正常生活时间以及手术并发症情况。结果 T管引流组术后发生胆瘘2例(3.4%),一期缝合组术后发生胆瘘1例(2.0%),其差异无统计学意义(P>0.05)。2组患者的手术时间、住院时间及住院治疗费用的差异均无统计学意义(P>0.05)。一期缝合组患者术后恢复正常生活时间为(7.2±1.1) d,短于T管引流组的(28.2±2.7)d(P=0.001)。结论 经腹腔镜胆道探查术后一期胆总管缝合是安全可行的,可缩短患者的康复时间,提高患者围手术期生活质量。

    Release date:2016-09-08 10:25 Export PDF Favorites Scan
  • Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones

    ObjectiveTo investigate the efficacy and safety of laparoscopic cholecystectomy and common bile duct exploration(LCBDE) with biliary stent drainage or T tube drainage. MethodsThe clinical data of 68 cases of gallbladder and bile duct stones with the LCBDE by the same surgeon in our hospital from June 2008 to June 2013 were retrospectively analyzed. Twenty-two patients were treated with LCBDE and biliary stent drainage(stent drainage group), 46 patients were treated with LCBDE and T tube drainage(T tube drainage group). ResultsThe operation were successfully completed of 2 groups. The anal exhaust time, peritoneal drainage time, postoperative hospitalization time, and hospital expenses in stent drainage group were shorter or less than thoes T tube drainage group(P < 0.05). There were no significant difference in the operative time, postoperative bilirubin level, and incidences of postoperative complications between the two groups(P > 0.05). ConclusionsThe stent drainage and T tube drainage after LCBDE has its own indications. Laparoscopic common bile duct exploration and biliary stent drainage is superior to the laparo-scopic common bile duct exploration and T tube drainage.

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  • Effect of Primary Closure Versus T-Tube Drainage after Laparoscopic Common Bile Duct Exploration

    目的比较腹腔镜下胆总管探查一期缝合与T管引流治疗肝外胆管结石的效果,总结腹腔镜下胆总管探查一期缝合的临床经验。 方法回顾性分析2010年1月至2012年12月期间于中国人民解放军总医院施行腹腔镜下胆总管探查取石的121例肝外胆管结石患者的临床资料,比较一期缝合组(n=63)与T管引流组(n=58)的手术时间、术中出血量、术后住院时间、胆瘘发生率、胆总管狭窄发生率及结石复发率。 结果2组患者均顺利完成腹腔镜手术。术后一期缝合组发生胆瘘3例,T管引流组发生1例。2组患者的术中出血量和胆瘘发生率比较差异均无统计学意义(P>0.05),但T管引流组的手术时间和术后住院时间均较长(P=0.000)。术后所有患者获访4~36个月,平均12个月。随访期间均无复发、胆总管狭窄及死亡发生。 结论腹腔镜下胆总管探查一期缝合治疗肝外胆管结石安全而有效,并且避免了术后T管的护理,有望成为处理肝外胆管结石的主流术式。

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  • 腹腔镜胆总管探查术后一期缝合与T管引流的临床研究

    目的探讨腹腔镜胆总管探查术后一期缝合与T管引流的手术疗效。 方法回顾性分析2012年1月至2013年12月期间太仓市第一人民医院肝胆外科行腹腔镜胆总管探查术50例患者的临床资料,其中18例行胆总管一期缝合,32例行胆总管T管引流,分析2组患者的临床疗效。 结果50例患者无中转开腹,均治愈出院。缝合组及引流组平均胆总管直径分别为(10.6±1.5)mm及(11.3±1.5)mm,胆总管结石数分别为(3.0±2.0)枚及(3.2±2.2)枚,平均结石直径分别为(5.5±1.6)mm及(5.8±2.1)mm,其差异均无统计学意义(P>0.05)。缝合组和引流组手术时间分别为(107.9±20.3)min和(101.6±36.4)min,分别于手术后(3.8±1.0)d和(3.3±1.0)d拔除腹腔引流管,总住院时间分别为(11.6±3.1)d和(12.0±2.2)d,术后恢复时间分别为(8.9±0.9)d和(7.4±1.1)d,其差异也无统计学意义(P>0.05)。缝合组和引流组患者住院总费用分别为(14 525.1±2 274.6)元和(16 568.3±2 701.5)元,缝合组住院总费用低于引流组(P<0.05)。引流组术后有结石残留1例,发生胆汁漏1例;缝合组无并发症发生。 结论与T管引流相比,腹腔镜胆管探查术后一期缝合不增加手术时间、总住院时间、术后恢复时间及术后引流时间,而能减少住院总费用,在合适的病例中,腹腔镜下胆总管探查术后一期缝合安全有效。

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  • 腹腔镜胆总管探查术后胆总管一期缝合与T管引流的疗效观察

    目的比较腹腔镜胆总管探查术后胆总管一期缝合与T管引流对临床治疗胆总管结石患者的影响 方法将2012年4月至2015年12月期间笔者所在医院收治的胆总管结石拟行腹腔镜胆总管切开取石术的90例患者作为研究对象,按随机数字表法分为观察组和对照组,数字为偶数者为观察组,奇数者为对照组,每组45例。观察组进行胆总管一期缝合,对照组行T管引流,记录并比较2组患者的手术情况及术后恢复情况,并对2组术后并发症的发生情况进行比较。 结果观察组手术时间明显短于对照组,差异有统计学意义(P<0.05),2组术中出血量比较差异无统计学意义(P>0.05);观察组患者术后肛门排气时间、下床活动时间、住院时间及恢复工作时间均明显短于对照组,差异有统计学意义(P<0.05);此外观察组住院费用亦明显少于对照组,差异有统计学意义(P<0.05);观察组患者术后并发症的发生率明显低于对照组,差异有统计学意义(P<0.05)。 结论在严格掌握相关适应证的前提下,采用腹腔镜胆总管切开取石一期缝合临床效果显著,具有手术时间短、术后恢复快、安全性高的优势,值得在临床推广使用。

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  • Clinical observation of primary suture following laparoscopic common bile duct exploration in patients aged over 70 years old with common bile duct stones

    Objective To explore clinical effect of primary suture following laparoscopic common bile duct exploration (LCBDE) in treatment of patients aged over 70 years old with common bile duct (CBD) stones. Methods The clinical data of 62 patients aged over 70 years old with CBD stones underwent the LCBDE from January 2013 to December 2016 were retrospectively analyzed. Among them, 30 patients underwent the T tube drainage (T tube drainage group) and 32 patients underwent the primary suture (primary suture group) following the LCBDE. The intraoperative and postoperative statuses of these two groups were compared. Results There were no significant differences in the gender, age, body mass index, preoperative comorbidities and ASA classification, number and maximum diameter of CBD stone, and diameter of CBD between the two groups (P>0.05). There were no significant differences in the operative time, hospitalization cost, rates of total postoperative complications and readmission between the two groups (P>0.05). Compared with the T tube drainage group, the amount of intraoperative bleeding was less (P<0.05) and the postoperative hospital stay was shorter (P<0.05) in the primary suture group. Conclusion Primary suture is safe and feasible following LCBDE for patients aged over 70 years old with CBD stones in case of strict indications and proficiency intraoperation and it is more beneficial to recovery of patient.

    Release date:2018-10-11 02:52 Export PDF Favorites Scan
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