담도절개 후 단순일차봉합과 T-관 삽입배액술의 비교

• Published in: Annals of surgical treatment and research p. 10
• Main Authors: 정금오, 권정남, 박동은, 소병준, 채권묵
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.07.2003
• Subjects: 일반외과학
• ISSN: 2288-6575; 2288-6796

Purpose: The placement of a drainage tube in the common bile duct, following a choledochotomy, has become accepted as routine procedure since it was first reported, by Abbe, in 1892. However, many complications are associated with T-tube drainage, such as bile peritonitis after its removal, accidental dislodgement, bile leakage from the T-tube track and a high incidence of postoperative bacteremia, have been reported. This study was designed to evaluate the primary closure as a suitable surgical technique in placce of T-tube drainage following a choledochotomy Methods: Between January and December 2002, primary closures were performed in 41 cases and T tube drainage in 112, following a choledochotomy. These cases were divided into 2 groups (group A: primary closure, and group B: T-tube drainage). The medical records of the patients were reviewed, and the following data analysed - age, sex, preoperative laboratory value, intraoperative finding, postoperative laboratory value, complication, and days of postoperative hospital stay. Results: There were no significant differences observed in the data of the investigated parameters, with the exception of the mean post-operative hospital stay. The mean post- operative hospital stays were 11.82 and 18.08 days in groups A and B (P=0.0034), respectively. The complication rates of each group showed no statistical difference. However bile peritonitis or bile leakage after T-tube removal developed 5 cases from group B. There were 2 and 5 deaths due to MODS & ARDS, respectively. Conclusion: A primary closure, following a choledochotomy, may be a suitable alternative technique to T-tube drainage under reasonable conditions. (J Korean Surg Soc 2003; 65:55-60) KCI Citation Count: 1