T 型管支撑法在胆肠吻合术中的应用价值

摘要

目的：探讨一种T型管支撑法在胆肠吻合术中的价值。方法：回顾性分析41例胆肠吻合术患者的临床资料。按随机分组原则分成T型管支撑胆肠吻合口组（研究组）及直接胆肠吻合组（对照组）两组，并随访1～2年，比较两组的减黄效果、胆漏及胆肠吻合口狭窄的发生率。结果：两组具有相同的减黄效果；术后胆漏发生率研究组明显低于对照组；术后第1年随访研究组胆肠吻合口狭窄率低于对照组（P＜0．05），第2年随访两组无明显统计学意义（0．1＞ P＞0．05）。结论：T型管支撑胆肠吻合口法能有效预防胆肠吻合术早期胆漏的发生，对远期胆肠吻合口狭窄的预防尚缺乏证据。%Objective:To investigate the value of a T-tube stent method in choledochojejunostomy .Methods:Clinical data of 19 cases of T-tube stent choledochojejunostomy(study group) and 22 cases of choledochojejunostomy without T-tube stent(control group) were analysed and compared ,the patients of the 2 groups were followed-up for 1 to 2 years .The serum level of total bilirubin and the morbidity of Bile leakage and anastomotic stricture between the 2 groups were compared .Results:The postoperative serum level of total bilirubin decreased to the same level in both groups (P>0 .05) .About the morbidity of Bile leakage ,study group was significantly lower than the control group (P<0 .05) .After the first year of follow-up ,about the morbidity of anastomotic stricture ,study group was significantly lower than the control group (P<0 .05) ,After the second year of follow-up ,there was no statistically significant be-tween study group and control group(0 .1> P>0 .05) .Conclusion:T-tube stent method anastomotic method can effec-tively prevent choledochojejunostomy early bile leakage ,anastomotic stricture of long-term prevention lack of evidence .