The Safety and Efficacy of Primary Duct Closure without Endoscopic Nasobiliary Drainage after Laparoscopic Common Bile Duct Exploration.

IF 0.8 Q4 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal Tumors Pub Date : 2020-10-01 Epub Date: 2020-08-12 DOI:10.1159/000508874

Yan Yang, Lin Han, Da-Ning Lin, Zeng-Ji Hu, Wei Tu, Feng Chen, Yong-Qiang Li

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引用次数: 5

Abstract

Background: Primary duct closure (PDC) after laparoscopic common bile duct exploration (LCBDE) has been widely applied for choledocholithiasis. However, there has been controversy over the placement of endoscopic nasobiliary drainage (ENBD) during operation. To date, few studies compare the clinical effect of PDC without and with ENBD. The aim of this study was to assess the safety and efficacy of PDC without ENBD for choledocholithiasis.

Methods: From January 2016 to December 2018, a total of 164 patients meeting the inclusion criteria were enrolled and divided into group A (undergone LCBDE + PDC without ENBD, 81 cases) and group B (undergone LCBDE + PDC with ENBD, 83 cases) in this study. The intraoperative conditions and postoperative complications were compared between the 2 groups.

Results: In group A, the time of operation, postoperative first flatus, extubation, antibiotics, and discharge were shorter than in group B (t = -17.775, p = 0.000; t = -7.649, p = 0.000; t = -5.807, p = 0.000; t = -9.247, p = 0.000; t = -9.322, p = 0.000, respectively). Furthermore, intraoperative blood loss was less (t = -2.199, p = 0.029) and hospital costs were lower (t = -6.685, p = 0.000). However, there was no significant difference in postoperative complications between the 2 groups (p > 0.05).

Conclusions: In patients who meet the screening criteria, PDC without ENBD after LCBDE is safe and effective and worthy of clinical application.

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腹腔镜胆总管探查术后不经鼻胆管引流一期管封闭的安全性和有效性。

背景:腹腔镜胆总管探查术(LCBDE)后一期胆总管闭合术(PDC)已广泛应用于胆总管结石的治疗。然而，手术中内镜下鼻胆道引流术(ENBD)的放置一直存在争议。迄今为止，很少有研究比较无ENBD和有ENBD的PDC的临床效果。本研究的目的是评估无ENBD的PDC治疗胆总管结石的安全性和有效性。方法:2016年1月至2018年12月，本研究共纳入164例符合纳入标准的患者，分为a组(行LCBDE + PDC，无ENBD, 81例)和B组(行LCBDE + PDC，合并ENBD, 83例)。比较两组患者术中情况及术后并发症。结果:A组患者手术时间、术后首次排气时间、拔管时间、抗生素使用时间、出院时间均短于B组(t = -17.775, p = 0.000;T = -7.649, p = 0.000;T = -5.807, p = 0.000;T = -9.247, p = 0.000;T = -9.322, p = 0.000)。术中出血量较少(t = -2.199, p = 0.029)，住院费用较低(t = -6.685, p = 0.000)。两组术后并发症发生率比较，差异无统计学意义(p > 0.05)。结论:在符合筛查标准的患者中，LCBDE术后无ENBD的PDC是安全有效的，值得临床推广。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal Tumors GASTROENTEROLOGY & HEPATOLOGY-

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审稿时长

17 weeks