[1]刘楠,刘奇①,崔伟②,等.经胆囊管细管引流测胆道压力对胆总管切开一期缝合的指导意义[J].中国微创外科杂志,2017,17(10):902-904.
　Liu Nan*,Liu Qi*,Cui Wei,et al.Significance of Bile Duct Pressure Measurement Through Trans-cystic Fine Tube on Choledochotomy and Primary Suture[J].Chinese Journal of Minimally Invasive Surgery,2017,17(10):902-904.
点击复制

经胆囊管细管引流测胆道压力对胆总管切开一期缝合的指导意义()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年10期
页码:
902-904
栏目:
临床研究
出版日期:
2017-10-20

文章信息/Info

Title:
Significance of Bile Duct Pressure Measurement Through Trans-cystic Fine Tube on Choledochotomy and Primary Suture
作者:
刘楠; 刘奇①; 崔伟②; 董加纯; 朱绍凤; 张俏; 张立娟; 陈德兴**(吉林省前卫医院普外科; 长春130012)
吉林省前卫医院普外科，长春130012
Author(s):
Liu Nan*;  Liu Qi*;  Cui Wei;  et al.
*Department of General Surgery, Jilin Qianwei Hospital, Changchun 130012, China
关键词:
腹腔镜; 一期缝合; 胆道压力; 胆道测压
Keywords:
Laparoscope; Primary suture; Bile duct pressure; Manometry of biliary tract
文献标志码:
A
摘要:
目的通过经胆囊管细管引流测量术后不同时间患者的胆道压力，观察是否存在术后压力持续增高。方法2013年1月～2014年6月对52例行腹腔镜胆囊切除，胆总管切开取石一期缝合术行胆道压力测定。采用经胆囊管留置细管进入胆道进行测压，通过中心静脉压的装置测量，分别测定术后第3、7、11天胆道压力。结果3例术后第3天出现胆漏，第6天消失。所有患者顺利出院，无并发症。术后第3、7、11天胆道压力分别为（20.49±1.44）、（16.09±1.48）、（11.29±1.74）cm H2O，两两比较均有统计学差异（P均=0.000）。结论腹腔镜下胆囊切除，胆总管切开取石一期缝合术后胆道压力逐渐降低，胆漏最可能在术后3 d左右发生，术后第7、11天后胆漏的机会明显减少。一期缝合的病人出院时并不增加胆道压力，不增加出院后胆漏风险。
Abstract:
ObjectiveTo measure the bile duct pressure at different postoperative days through trans-cystic fine tube to observe whether the bile duct pressure is continuously elevated after choledochotomy and primary suture. MethodsFrom January 2013 to June 2014, 52 patients undergoing laparoscopic cholecystectomy with choledochotomy and primary suture were included. A fine tube was put through the cystic tube intra-operatively. The bile duct pressures at postoperative 3, 7, and 11 days were evaluated through the trans-cystic tube with a device used to measure the central venous pressure. ResultsBile leakage occurred in 3 patients at postoperative 3 days and was resolved at 6 days postoperatively. All the patients were discharged from hospital smoothly without complications. The bile duct pressures were (20.49±1.44), (16.09±1.48), and (11.29±1.74) cm H2O at postoperative 3, 7, and 11 days, with significant differences between each other (P=0.000). ConclusionsBile duct pressure gradually decreases after laparoscopic cholecystectomy with choledochotomy and primary suture. Bile leakage is more likely to occur at 3 days than 7 and 11 days after the surgery. Bile duct pressure and postoperative bile leakage are not prone to be increased after primary suture.

参考文献/References:

[1]潘成文，吴育连.腹腔镜与开腹胆总管取石一期缝合的临床比较.中国微创外科杂志,2016,16(6):518-521.
[2]蒋能孟，胡邓迪.鼻胆管代替 T 管在腹腔镜胆总管切开一期缝合中的应用.中国微创外科杂志,2014,14（4）：314-316.
[3]肖宏，索运生，尹思能，等.腹腔镜胆总管探查一期缝合术中经胆囊管输尿管导管胆道引流 607 例.中国微创外科杂志,2015,15（12）:1072-1074.
[4]索运生,张明哲,尹思能.腹腔镜胆总管探查、一期缝合和T管引流后胆道压力变化的比较.中国微创外科杂志 2006,6(1):25-29.
[5]王选,任昌安,王志如，等.胆道术后T管测压的临床意义.山西医药杂志，1991,20(4):204-205.
[6]Pylypchuk VI. Surgical treatment of chronic pancreatitis complicated by biliary hypertension. Klin Khir,2015,1(1):22-24.
[7]Tsui WM, Lam PW, Lee WK, et al. Primary hepatolithiasis, recurrent pyogenic cholangitis, and oriental cholangiohepatitis: a tale of 3 countries. Adv Anat Pathol,2011,18(4):318-328.
[8]Strnad P, Von Figura G, Gruss R, et al. Oblique bile duct predisposes to the recurrence of bile duct stones. PLoS One,2013,8(1):e54601.
[9]Nuzzo G, Clemente G, Giovannini I, et al. Liver resection for primary intrahepatic stones: a single-center experience. Arch Surg,2008,143(6):570-573.

备注/Memo

备注/Memo:
基金项目：吉林省卫计委科研立项（项目编号：7011S032）**通讯作者，E-mail：jlchendexing@163.com①并列第一作者②（长春医学高等专科学校，长春130031）
更新日期/Last Update: 2018-01-11