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首页> 外文期刊>Surgical Endoscopy >A randomized comparison of primary closure and T-tube drainage of the common bile duct after laparoscopic choledochotomy.
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A randomized comparison of primary closure and T-tube drainage of the common bile duct after laparoscopic choledochotomy.

机译：腹腔镜胆总管切开术后胆总管初次闭合和T管引流的随机比较。

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BACKGROUND: Traditionally, the common bile duct (CBD) has been closed with T-tube drainage after laparoscopic choledochotomy and removal of CBD stones. However, insertion of the T-tube is related to some potential postoperative complications, and patients must carry the T-tube for several weeks before its removal. Primary closure of the CBD without drainage has been proposed as a safe alternative to T-tube placement after laparoscopic choledochotomy. This randomized study aimed to compare the postoperative course and final outcome between the two methods applied after LCBDE. METHODS: Between January 2000 and January 2004, 80 patients treated with laparoscopic choledochotomy for CBD stones were randomly assigned to primary duct closure (n = 40) or T-tube drainage (n = 40). The primary end points were morbidity, operative time, postoperative stay, hospital expenses, and time until return to work. RESULTS: There were no differences in the demographic characteristics or clinical presentations between the two groups. In the primary closure group, the postoperative stay (5.2 +/- 2.2 vs 8.3 +/- 3.6 days) and the time until return to work (12.6 +/- 5.1 vs 20.4 +/- 13.2 days) were significantly shorter, the hospital expenses (8,638 +/- 2,946 vs 12,531 +/- 4,352 yuan) were significantly lower, and the incidences of postoperative complications (15% vs 27.5%) and biliary complications (10% vs 20%) were statistically and insignificantly lower than in the T-tube drainage group. In the primary closure group, six patients experienced postoperative complications, four of whom had biliary complications, compared, respectively, with 11 and 8 patients in the T-tube drainage group. CONCLUSIONS: This study showed that primary CBC closure after laparoscopic choledochotomy was a viable alternative to mandatory T-tube drainage.
机译：背景：传统上，腹腔镜下胆总管切开术和清除CBD结石后，通过T管引流闭合胆总管（CBD）。但是，插入T形管与一些潜在的术后并发症有关，患者必须在T形管移除前将其携带数周。已经提出，在不进行引流的情况下，首先封闭CBD可作为腹腔镜胆总管切开术后T管放置的安全替代方法。这项随机研究旨在比较LCBDE后应用的两种方法的术后进程和最终结局。方法：2000年1月至2004年1月，将80例接受腹腔镜胆总管切开术治疗CBD结石的患者随机分配为一次主动脉导管闭合术（n = 40）或T管引流术（n = 40）。主要终点是发病率，手术时间，术后住院时间，住院费用和恢复工作的时间。结果：两组的人口统计学特征或临床表现无差异。在初级封闭组中，术后住院时间（5.2 +/- 2.2 vs 8.3 +/- 3.6天）和恢复工作的时间（12.6 +/- 5.1 vs 20.4 +/- 13.2天）明显缩短，医院费用（8,638 +/- 2,946对12,531 +/- 4,352元）显着降低，术后并发症（15％对27.5％）和胆道并发症（10％对20％）的发生率在统计学上显着低于T型管引流组。在初级封闭组中，有6例发生了术后并发症，其中4例患有胆道并发症，而T型管引流组分别为11例和8例。结论：这项研究表明，腹腔镜胆总管切开术后原发性CBC封闭是强制性T管引流的可行替代方法。

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