Comparison Of Clinical Efficacy Between Primary Suture And T-tube Drainage In Laparoscopic Common Bile Duct Exploration

Objective: The surgical methods for common bile duct stones include primary bile duct suture and T-tube drainage after common bile duct exploration and stone removal.By comparing the operation time,postoperative gastrointestinal function recovery time,postoperative hospital stay,hospitalization cost and postoperative operation The incidence of complications is used to evaluate the clinical efficacy.Methods: A retrospective analysis was performed on 74 patients who underwent laparoscopic common bile duct exploration and lithotripsy in the Affiliated Hospital of Northwest Minzu University and Gansu Provincial People’s Hospital from January 2018 to January 2020.The preoperative general conditions,intraoperative surgical data,postoperative recovery and complications of the primary suture group and the T-tube drainage group were compared.Results: A total of 74 cases were gathered in this study,including 34 cases in the primary suture(PS)group and 40 cases in the T-tube drainage(TD)group.After statistical analysis:1.There was no significant differences in age and gender between the two groups(P>0.05);2.There was no significant differences in the diameter of the common bile duct in preoperative imaging(P>0.05).There was multiple and single stone.There was not any statistically significant differences in the number of patients(P>0.05);3.There was no statistically significant differences in jaundice indexes between the two groups before operation(P>0.05),and the jaundice indexes were significantly reduced on the third day after surgery,but the difference was not statistically significant(P>0.05);4.There was no statistically significant differences in intraoperative blood loss(P>0.05).The operation time(min)in the TD group(131.63±35.97)was significantly greater than that in the PS group(113.53±25.92),and the differences was statistically significant(P < 0.05);5.The first postoperative exhaust time(d)PS group(2.66±0.68)is shorter than TD group(2.23±0.76),drainage(ml)PS group(37.13±7.24)is less than TD group(28.82±10.0),the postoperative hospital stay(d)in the PS group(7.35±2.31)was less than that in the TD group(5.94±1.50),and the hospitalization expense(10,000 yuan)in the PS group(2.30±0.51)was lower than that in the TD group(2.59±)0.69),the difference was statistically significant(P<0.05);6.Postoperative complications occurred in the two groups,and there was no statistically significant differences in the incidence of complications(P>0.05).Conclusion: 1.For patients with common bile duct stones,primary suture of the bile duct after laparoscopic common bile duct exploration does not increase the risk of bile leakage.Compared with T-tube drainage,the postoperative recovery is faster,the hospital stay is shorter,the cost is less,and the the need for indwelling T-tube is more in line with the concept of minimally invasive surgery.2.Under the condition of strictly grasping the indications,the primary suture is safe and feasible,and the cost performance is higher than that of T-tube drainage.