The Analysis Of The Clinical Application Of Abdominal Drainage In Primary Closure Of Laparoscopic Common Bile Duct Exploration

When the abdominal cavity with purulent material,necrotic tissue,sinus and fistula,or special circumstances in order to prevent the wound closed prematurely placed abdominal drainage called therapeutic drainage.But if only to prevent blood,pus,bile and intestinal contents,pancreatic juice and other abnormal liquid accumulated in the body before placing peritoneal drainage.It is a preventive drainage for the early detection of complications.In recent years,the technology of Department of hepatobiliary surgery,the management of perioperative period and the concept of ERAS have been developing continuously.There is a gradual divergence of understanding of the need for conventional indwelling preventive abdominal drainage after minimally invasive surgery for biliary tract.Especially for laparoscopic common bile duct exploration and primary closure,who has been gradually recognized in the clinic.This thesis is a research on this problem.The safety and superiority of the preventive abdominal drainage tube after LCBDE+PC were discussed.First of all,this study was approved by the doctor's ethics committee,and both the patients and their families signed the informed consent.A prospective study of 40 patients with LCBDE+PC from May 2016 to March 2018 at the hepatobiliary surgical ward,affiliated to the Zhongshan hospital,Xiamen University,was performed.All patients were free of the following conditions:abnormal cardiopulmonary disease,abnormal bleeding,or coagulation function,abnormal liver and kidney function,ulcers,etc.The two groups of patients with general data such as sex,age,primary disease and other differences were not statistically significant(P>0.05),and were comparable.40 cases of qualified cases were randomly divided into two groups,with 20 cases in each group.In the operation without placement of peritoneal drainage for the experimental group,the control group for placement of peritoneal drainage.Study on the premise that other interfering factors are consistent.The operative time,hospitalization time,hospitalization expenses,postoperative hospitalization time,postoperative pain time,intraoperative bleeding,postoperative bilirubin returned to normal,postoperative leukocyte recovery time and operative complications were compared between the two groups.To evaluate the therapeutic effect of no preventive abdominal drainage tube after LCBDE+PC.The results showed that,there was no significant difference between the two groups in the cost of hospitalization,intraoperative bleeding,postoperative bilirubin and inflammatory indexes to the normal time(P>0.05).But the time of postoperative hospitalization and the time of postoperative wound pain were significantly less in the no drainage group(P<0.05).The recovery of white blood cells to normal time was also short after operation.In addition,there were no complications such as bile leakage,infection(biliary tract,incision,surgical related infection),pancreatitis,residual stone,obstructive jaundice,biliary stricture after operation in the two groups.This study indicates that in laparoscopic primary exploration of biliary tract,no longer preventive placement of peritoneal drainage for patients who meet the inclusion criteria has the advantages of faster recovery time,shortening the duration of antibiotic use and reducing postoperative pain.Better embodies the idea of ERAS.It is feasible in clinical efficacy and safety,and it is valuable in clinical application.