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group comparison analysis for the effect of cbd exploration between t tube and primary closureword论文.docx

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group comparison analysis for the effect of cbd exploration between t tube and primary closureword论文

List ofContents5GroupcomparisonanalysisfortheeffectofCBD exploration betweenTtubeandprimary closure.ABSTRACTObjective:Thepurposeofthis prospective randomized studywas to comparethe post operativeshort term andmidterm complications in patients whounderwent CBD exploration byusingT-tube and primaryclosure.Study design:Prospective randomized clinical trial.Place＆Durationofstudy:HepatobiliaryDepartmentofFirstAffiliatedHospitalof XinjiangMedical UniversityUrumqi China fromAugust 2009 to March 2013. Methods:Atotalof148consecutivepatientswithcommonbileductstones(CBDS) and CBD dilation were enrolled in this randomized study to undergo open cholecystectomywithCBDexploration.Preoperativefindings,postoperativeshortterm complications, postoperative follow up (midterm), and hospital stay were recorded andanalyzed.Results:AT-tubewasinsertedin76(51.35%)patientsandtheprimaryclosurewas donein72(48.64%)patients.Therewerenodifferencesinthedemographic characteristicsandclinicalpresentationsbetweenthetwogroups.Comparedwiththe T-tubegroup8.97±1.629(days),thepostoperativestayinprimaryclosure 5.34±1.25(days)weresignificantlyshorter(p=0.01).Theincidenceofoverall postoperativeshorttermcomplicationsandmidtermcomplicationswerestatistically andinsignificantlylowerinprimaryclosuregroup(9.7%)thanthatinT-tubegroup (17.10%)with (p=0.189).Conclusion:Sampleofourclinicalcomparisontrialindicatesthatcomplicationsin primarygrouplowerthanthatinTtubegroupbutthereisnosignificantstatistical difference.SoduringopensurgeryforCBDstones,primaryclosureofCBDappeared safeandeffectivewith shorter hospital staysand less complications.Keywords: Open Common bile duct exploration, Postoperative complications, T-tubes, Primaryclosure.1IntroductionCholedeocholithiasisdevelopsinalmost10–15%ofpatientswithcholelithiasis anddifferentstudiessuggestthatcholedocholithiasisareencounteredinabout7–15% ofpatientsunderwentcholecystectomy.[1,2,3]Thesepatientsmayrequiresurgical interventiontoremovestones,suchascholedochotomy,inwhichind