关键词: 胆管结石, 胆总管探查, 胆管一期缝合, 胆管支架置入, 胆道镜取石

Abstract: Objective   To compare the efficacy and safety of single pig-tail biliary stent placement under choledochoscopy followed by primary common bile duct closure with traditional T-tube drainage after laparoscopic common bile duct exploration.   Method  A total of 98 cases who underwent laparoscopic common bile duct exploration in our hospital from June 2019 to June 2022 were included retrospectively.They were divided into bile duct stents group (BD-stent group,40 cases) and the T-tube drainage group (TTD group,58 cases) according to the surgery type.The general conditions,intraoperative indicators,postoperative recovery and complications in two groups were statistically compared.   Result   In terms of surgery,the BD-stent group had significantly less surgery time,bile-duct-operation time,bleeding volume,postoperative VAS index and Caprini score than the TTD group (P<0.05).Both groups had no mortality or reoperation.There were no significant differences in first-day serum total bilirubin,γ-GT and total analgesia usage between two groups(P>0.05).But the first-day serum albumin,anal ventilation time,antibiotic usage,leukocyte recovery days,drain-tube removal days,bile duct drainage days,postoperative hospital stay and total costs in BD-stent group were significantly better than those in TTD group (P<0.05).As for postoperative complications,the rate in BD-stent group and TTD group were respectively 5.0% and 6.9%,without significant differences (P>0.05).  Conclusion   Single pig-tail biliary stent placement under choledochoscopy followed by primary common bile duct closure has unique advantages in safety and rapid recovery.It avoids long-term drainage.

Key words: Cholelithiasis, laparoscopic common bile duct exploration, primary duct closure, Bile duct stent, Choledochoscopic lithotomy