CAJ | 학술논문

目的建立胆总管探查术后胃胆管引流、胆总管一期缝合的动物模型(简称胃胆管引流术),探讨胃胆管引流术的可行性和临床价值.方法将30只犬随机分为3组:对照组(仅行腹腔探查,n=5),胆总管一期缝合组(简称一期缝合组,n=10),胃胆管引流、胆总管一期缝合组(简称胃胆管组,n=15).观察术后肝功能的变化、胆漏等并发症,评估胃胆管引流术的安全性.结果对照组术后无一血清总胆红素(TBil)升高.一期缝合组术后3只犬血清TBil显著升高,4只犬血清TBil轻度升高;胃胆管组术后无一血清TBil显著升高,后两者差异有统计学意义(P＜0.01).胃胆管组平均拔管时间(7.0±1.7)d,无一发生胆漏、腹腔感染及切口感染、裂开;一期缝合组术后5只犬胆漏,其中3只犬发生胆汁性腹膜炎,两者差异有统计学意义(P＜0.05).结论胃胆管引流术安全可行,胆道引流时间短、避免了胆总管一期缝合术后胆漏等并发症,具有其独特的临床应用价值.
목적건립담총관탐사술후위담관인류、담총관일기봉합적동물모형(간칭위담관인류술),탐토위담관인류술적가행성화림상개치.방법장30지견수궤분위3조:대조조(부행복강탐사,n=5),담총관일기봉합조(간칭일기봉합조,n=10),위담관인류、담총관일기봉합조(간칭위담관조,n=15).관찰술후간공능적변화、담루등병발증,평고위담관인류술적안전성.결과대조조술후무일혈청총담홍소(TBil)승고.일기봉합조술후3지견혈청TBil현저승고,4지견혈청TBil경도승고;위담관조술후무일혈청TBil현저승고,후량자차이유통계학의의(P＜0.01).위담관조평균발관시간(7.0±1.7)d,무일발생담루、복강감염급절구감염、렬개;일기봉합조술후5지견담루,기중3지견발생담즙성복막염,량자차이유통계학의의(P＜0.05).결론위담관인류술안전가행,담도인류시간단、피면료담총관일기봉합술후담루등병발증,구유기독특적림상응용개치.
Objective To establish an animal model with installation of gastrobiliary duct drainage (GBDD) in the primary suture after exploration of common bile duct, to assess the safety and feasibility of GBDD. Methods Thirty dogs were randomly divided into three groups: control group (n=5), primary suture group (n= 10) and GBDD group (n= 15). Serum TBil levels, bile leakage,and complications were observed and compared. Results No increase in serum TBil level was observed in the control group. However, serum TBil levels were significantly increased in the primary suture group compared to the GBDD group (P＜0. 01). GBDD were all successfully withdrawn at mean (7. 0±1.7) days after the operation. No bile leakage was found in the GBDD group, which was significantly different compared to 5/10 bile leakage cases in primary suture group (P＜0. 05). There were 3/10 cases of bile peritonitis, infection of incisional wound and splitted in the primary suture group, while there were no such complications in the GBDD group (all P＞0.05). Conclusions GBDD is safe and feasible. It can shorten biliary drainage time and prevent occurrence of bile leakage.Therefore, it has unique value in clinical application.