Effect Of Gauze Swab Method On The T-Tube Sinus Tract During Laparoscopic Bile Duct Exploration

Objective To explore the effect of gauze swab method on laparoscopic cholecystectomy combined with common bile duct exploration T-tube sinus tract,and analyze postoperative recovery and cost of the patients to provide reference for clinical decision-making.Methods This study was conducted from November 2018 to November 2019 in the general Surgery department of Minda Hospital of Hubei Minzu University.A total of 100 patients with cholecystocholedocholithiasis underwent LCBDE were selected to the entry criteria and divided into swab group(n=50)and common group(n=50)by random digital table method.To compared with the age,sex,stone size and number,intraoperative blood loss,abdominal drainage volume,inflammatory index,length of hospital stay,surgical time,integrity and thickness of T-tube sinus tract,the rate of bile leakage,incidence of intestinal obstruction and the cost of treatment between the two groups.Result Both the age,sex,stone diameter and number,common bile duct diameter,type of T-tube and associated basic diseases between the two groups had no significant difference.Both the operation time,intraoperative blood loss,first time out of bed,postoperative intestinal function recovery,abdominal drainage volume,length of hospital stay and cost of treatment between the two groups had no significant difference.Compared with common group,swab group preoperative and postoperative levels of white blood cells were(5.88±1.86)*10~9/L,(10.90±2.01)*10~9/L vs(6.17±0.98)*10~9/L,(10.38±1.79)*10~9/L.Compared with common group,swab group preoperative and postoperative levels of C reactive protein were(8.41±1.72)mg/L,(19.11±8.05)mg/L vs(8.46±2.05)mg/L,(21.18±6.74)mg/L.There was a slight increase in postoperative WBC and CRP levels,but there was no significant difference between the two groups(P>0.05).At the2nd,3rd and 4th weeks after operation,the rate of T-tube sinus completely formation in the swab group and the common group was 84%vs.66%,94%vs.88%,and 100%vs.96%.The rate of T-tube sinus completely formation in the swab group at the 2nd week after operation were significantly higher as compared to that in the common group.At the 2nd,3rd and 4th weeks,Median and interquartile spacing of T-tube sinus wall thickness between the swab group and the common group were2(2,3),4(3,5),5(5,6)vs 2(1,2),3(3,4),4(4,5).There was no bile leakage in the swab group,and the rate of bile leakage was 8.5%in the common group.The T-tube sinus wall thickness and the rate of bile leakage between the two groups were statistically significant.Conclusion Gauze swab method is guaranteed in feasibility,efficacy,safety and economy.It is a safe,feasible,easy to implement and has clinical popularization value.