CAJ | 학술논문

目的探讨腹腔镜与开腹胆总管切开探查术中选择性放置双肩猪尾巴内支架管(以下简称支架管)及胆总管切口原位缝合的方法、效果及可行性.方法 48例胆总管结石患者分别采用腹腔镜(n=12)或开腹手术(n=36).完成胆总管切开探查取石后,通过导丝将支架管的远端置入十二指肠,原位缝合胆总管切口.结果支架管均于术后随粪便自行排出,平均排出时间为14(10 ～18)d,其中7例患者术后血清淀粉酶出现短暂性轻微升高.无胆漏、提前脱管、堵管或支架管滞留胆管等并发症.结论胆总管探查术中选择性经导丝向胆总管和十二指肠内放置自行脱落的支架管并原位缝合胆总管切口是有效的胆管引流方法.该法既方便又安全,可减少放置“T”型管引流的相关并发症.
목적 탐토복강경여개복담총관절개탐사술중선택성방치쌍견저미파내지가관(이하간칭지가관)급담총관절구원위봉합적방법、효과급가행성.방법 48례담총관결석환자분별채용복강경(n=12)혹개복수술(n=36).완성담총관절개탐사취석후,통과도사장지가관적원단치입십이지장,원위봉합담총관절구.결과 지가관균우술후수분편자행배출,평균배출시간위14(10 ～18)d,기중7례환자술후혈청정분매출현단잠성경미승고.무담루、제전탈관、도관혹지가관체류담관등병발증.결론 담총관탐사술중선택성경도사향담총관화십이지장내방치자행탈락적지가관병원위봉합담총관절구시유효적담관인류방법.해법기방편우안전,가감소방치“T”형관인류적상관병발증.
Objective To study the efficacy of primary closure of choledochotomy with placement of a modified biliary stent after laparoscopic and conventional open common bile duct exploration.Methods 48 patients underwent laparoscopic (n =12) or open common bile duct exploration (n =36) for gallbladder and common bile duct (CBD) stones.After extraction of all CBD stones,the distal end of an 8F stent (pigtail) was placed into the duodenum over a guide wire.The CBD incision was closed primarily.Results The stent was dislodged and discharged with stool on the 14 (10 ～ 18) th postoperative day on average.Seven patients developed transient hyperamylasemia in the immediate postoperative period.No patients had the complications of bile leak,stent occlusion,early stent dislodgement,or stent retraction into the CBD.Conclusions Placement of a self-release biliary 8F stent in CBD and into the duodenum during common bile duct exploration is a safe and efficacious method.It can reduce the complications related to T-tubes.