Objective To study the feasibility and efficacy of treatment of extrahepatic cholangiolithiasis using laparoscopic self-releasing J-tube drainage combined with primary suturing of common bile duct.Methods The clinical data of 172 patients with extrahepatic cholangiolithiasis who underwent operations from March 2013 to January 2015 were retrospectively studied.The patients were divided into two groups:the J-tube drainage group (n =82) and the T-tube drainage group (n =90).Surgical duration,intraoperative bleeding,postoperative hospital stay,treatment cycles,hospital costs,incidences of postoperative bile leakage and residual extrahepatic cholangiolithiasis were compared between the two groups.Results The length of postoperative hospital stay in the J-tube drainage group was (4.9 ± 1.2) days and in the T-tube drainage group was (8.0 ± 2.0) days.The treatment cycles in the J-tube drainage group were (4.9 ± 1.2) days while in the T-tube drainage group were (24.1 ± 3.2) days.The hospital costs in the J-tube drainage group were (12 817.1 ±3 167.1) yuan and the costs in the T-tube drainage group were (15 012.5 ±2 354.8) yuan.There were significant differences in hospital stay,treatment cycles and hospital costs between the two groups (all P ＜ 0.05).The surgical duration in the J-tube drainage group was (108.2 ± 10.2) minutes and the duration in the T-tube drainage group was (110.1 ± 13.1) minutes.The amount of intraoperative bleeding in the J-tube drainage group was (35.0 ± 20.0) ml and the amount in the T-tube drainage group was (42.0 ±30.0) ml.There were no significant differences in intraoperative bleeding and surgical duration between the two groups (all P ＞ 0.05).No significant differences were observed in the incidences of post-operative bile leakage and in residual extrahepatic cholangiolithiasis between the two groups (P ＞ 0.05).Conclusions Self-releasing J-tube drainage combined with laparoscopic primary suturing of common bile duct was safe and efficacious.It was minimally invasive in treating patients with extrahepatic cholangiolithiasis.%目的 研究腹腔镜自行脱落J管引流、胆总管一期缝合术治疗肝外胆管结石的实用性及临床效果.方法 回顾性分析2013年3月至2015年1月陕西中医药大学附属医院住院手术的172例肝外胆管结石患者资料.按照手术方式分为J管组(自行脱落J管引流、胆总管一期缝合术)82例和T管组(T管引流术)90例.对比分析两组患者的手术耗时、术中失血、住院时间、治疗周期、住院花费以及术后胆漏、残余结石的发生率.结果 J管组和T管组的术后住院时间分别为(4.9±1.2)d和(8.0±2.0)d,治疗周期分别(4.9±1.2)d和(24.1 ±3.2)d,住院花费分别(12 817.1±3 167.1)元和(15 012.5±2 354.8)元,J管组均低于T管组,两组差异均具有统计学意义(均P＜0.05).J管组和T管组手术耗时分别为(108.2±10.2)min和(110.1±13.1)min,术中失血量分别(35.0±20.0)ml和(42.0±30.0)ml,两组差异均无统计学意义(均P＞0.05).两组术后胆漏、术后结石残留发生率的差别均无统计学意义(均P＞0.05).结论 腹腔镜自行脱落J管引流、胆总管一期缝合术具临床实用性,且安全可行并更加微创.
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