关键词: 肝外胆管结石, 腹腔镜, 胆总管探查术, 一期缝合, T管引流, 中青年病人

Abstract: Objective To compare the clinical efficacy of laparoscopic-assisted common bile duct exploration (LCBDE) one-stage suture and laparoscopic-assisted common bile duct exploration T-tube drainage in young and middle-aged patients with extrahepatic bile duct stones.Methods A total of 99 patients with extrahepatic bile duct stones were admitted from January 2021 to December 2024.According to the treatment methods,they were divided into two groups.There were 55 cases in the observation group,who were given primary suture after LCBDE,and 44 cases in the control group,who were given T-tube drainage after LCBDE.The operation time,intraoperative blood loss,postoperative drainage time,postoperative self-care ability score,postoperative intestinal function recovery time,total hospitalization cost,length of hospitalization,changes in liver function indexes,inflammatory indexes and postoperative pain score were compared between the two groups.Results The gender (male/female),age,number of stones,stone size and common bile duct inner diameter of the patients in the observation group were 27/28 cases,(58.33±3.68) years old,(2.36±1.43),(0.79±0.38) cm and (1.17±0.31) cm,respectively.The control groups were 23/21 cases,(56.44±8.79) years,(2.45±1.57) individuals,(0.88±0.54)cm and (1.29± <s:1> 0.38 cm)cm respectively.There was no statistical significance between the two groups (P>0.05).The operation time,hospital stay,abdominal drainage tube placement time and total cost of the observation group were (125.10±36.27) minutes,(9.58±2.58) days,(5.22±1.47) days and (22167.39±3569.69) yuan,respectively.The control groups were (161.45±37.24) minutes,(12.59±3.76) days,(6.79±2.55) days and (26479.88±5556.30) yuan respectively.There was a statistically significant difference between the two groups (P<0.05).The average postoperative self care ability score,average postoperative pain score and average postoperative intestinal function recovery time of the observation group were (1.89±0.88) points,(93.09±4.42) points and (2.98±0.82) days respectively.The control groups were (4.23±1.06) points,(82.50±9.97) points and (4.98±1.23) days respectively.There was a statistically significant difference between the two groups (P<0.05).There was no statistically significant difference in liver function indicators between the two groups before and 3 days after the operation (P>0.05).Conclusion One-stage suture has shown good clinical results in the treatment of extrahepatic bile duct stones in young and middle-aged patients.

Key words: extrahepatic bile duct stones, laparoscope, common bile duct exploration, primary suture, T-tube drainage, young and middle-aged patients