Application effect of intraoperative nasobiliary duct replacing traditional T tube in laparoscopic cholecystectomy and choledochotomy with primary suture
ZHAO Zhi-xin CHEN Geng-zhen▲ XU Rui-rui
Department of General Endoscopic Vascular Surgery, the Second Affiliated Hospital of Shantou University Medical College, Guangdong Province, Shantou 515041, China
Abstract：Objective To investigate the application value and clinical effect of intraoperative nasobiliary duct in replacing traditional T tube in laparoscopic cholecystectomy (LC) + choledochotomy with primary suture. Methods A total of 60 patients with choledocholithiasis simultaneously with cholecystolithiasis who were admitted to the Second Affiliated Hospital of Shantou University Medical College from January 2018 to December 2019 were selected as the research subjects, and were divided into the study group and the control group according to the random number table method, with 30 patients in each group. In the study group, LC + laparoscopic common bile duct exploration (LCBDE)+ endoscopic nasobiliary drainage (ENBD) were performed, while in the control group, LC + LCBDE + T tube drainage was performed. The intraoperative and postoperative conditions of the two groups were compared. Results All 60 cases were operated successfully. No significant differences were observed in operative durations, intraoperative blood losses,drainage volumes and postoperative gastrointestinal function recovery times between the two groups (P>0.05). The drainage tube extraction time and postoperative length of hospital stay in the study group were shorter than those in the control group, and the hospitalization cost in the study group was less than that in the control group, and the differences were statistically significant (P<0.05). All patients were followed up for 6 to 10 months, and reexamination showed that:no biliary tract stenosis occurred in the two groups, and no statistically significant difference was observed in the incidences of postoperative pancreatitis between the two groups (P>0.05). The increased rate of amylase in blood and urine and the abnormal rate of liver function in the study group were lower than those in the control group, with statistically significant differences (P<0.05). Conclusion Nasobiliary duct can replace T tube drainage in LC+LCBDE, which can guarantee the safety of primary suture of choledochotomy, and its efficacy is more accurate and feasible.
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