ABSTRACT
Objective To compare the efficacy of surgical drainage versus repair in the treatment of iatrogenic injury of the distal common bile duct detected during operation,and to evaluate the effect of gastrobiliary duct drainage.Methods Patients with iatrogenic choledochal injury were divided into two groups:the drainage group (n =17) and the repair group (n =7).Data on the amounts of postoperative biliary and abdominal cavity drainage,gastrointestinal function recovery,the duration of biliary drainage and hospitalization were compared.Results When compared with the repair group,there were no significant differences in the amounts of postoperative biliary drainage [(310.0± 112.0) vs.(264.0± 144.0) ml] and abdominal cavity drainage [(42.0±25.0) ml vs.(125.0± 195.0) ml)] (both P＞0.05).However,gastrointestinal function recovery [(3.0±1.5)d vs.(4.7±2.0)d],durations of biliary drainage [(7.5±1.0)d vs.(12.7±5.4)d] and hospitalization [(9.5±1.5)d vs.(15.1±5.6)d] of the drainage group were significantly shorter than the repair group (P＜ 0.05).No biliary strictures of cholangitis were detected in the two groups.Conclusion When compared with traditional repair,gastrobiliary drainage was a simpler,safer,and more effective therapeutic strategy for patients with iatrogenic distal common bile duct injury,and with a quicker recovery after treatment.
ABSTRACT
Objective To establish an animal model with installation of gastrobiliary duct drainage (GBDD) in the primary suture after exploration of common bile duct, to assess the safety and feasibility of GBDD. Methods Thirty dogs were randomly divided into three groups: control group (n=5), primary suture group (n= 10) and GBDD group (n= 15). Serum TBil levels, bile leakage,and complications were observed and compared. Results No increase in serum TBil level was observed in the control group. However, serum TBil levels were significantly increased in the primary suture group compared to the GBDD group (P＜0. 01). GBDD were all successfully withdrawn at mean (7. 0±1.7) days after the operation. No bile leakage was found in the GBDD group, which was significantly different compared to 5/10 bile leakage cases in primary suture group (P＜0. 05). There were 3/10 cases of bile peritonitis, infection of incisional wound and splitted in the primary suture group, while there were no such complications in the GBDD group (all P＞0.05). Conclusions GBDD is safe and feasible. It can shorten biliary drainage time and prevent occurrence of bile leakage.Therefore, it has unique value in clinical application.
