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The Safety and Efficacy of Primary Duct Closure without Endoscopic Nasobiliary Drainage after Laparoscopic Common Bile Duct Exploration
Gastrointestinal Tumors ( IF 0.8 ) Pub Date : 2020-08-12 , DOI: 10.1159/000508874
Yan Yang 1 , Lin Han 1 , Da-Ning Lin 1 , Zeng-Ji Hu 1 , Wei Tu 1 , Feng Chen 1 , Yong-Qiang Li 1
Affiliation  

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 #x3e; 0.05). Conclusions: In patients who meet the screening criteria, PDC without ENBD after LCBDE is safe and effective and worthy of clinical application.
Gastrointest Tumors


中文翻译:

腹腔镜胆总管探查后无内镜鼻胆管引流一期封堵术的安全性和有效性

背景:腹腔镜胆总管探查(LCBDE)后的原发性胆管闭合(PDC)已广泛应用于胆总管结石。然而,对于术中放置内镜下鼻胆管引流术(ENBD)一直存在争议。迄今为止,很少有研究比较 PDC 没有和有 ENBD 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,共纳入符合纳入标准的患者164例,分为A组(LCBDE+PDC+ENBD,81例)和B组(LCBDE+PDC+ENBD,83例)在这个研究中。比较2组术中情况及术后并发症。结果: A组手术时间、术后首次排气时间、拔管时间、抗生素用药时间、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)。此外,术中失血更少( t = -2.199, p = 0.029),住院费用更低( t = -6.685, p= 0.000)。然而,两组的术后并发症无显着差异(p #x3e;0.05)。结论:在符合筛选标准的患者中,LCBDE后不加ENBD的PDC安全有效,值得临床推广应用。
胃肠肿瘤
更新日期:2020-08-12
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