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经T管胆管引流术与经皮经肝胆管引流术治疗胆肠吻合口胆漏的回顾性研究

The trans T-tube cholangial drainage versus percutaneous transhepatic cholangial drainage for the treatment of bile leakage at the biliary-enteric anastomosis: a retrospective study.

作者信息

Yu Sun, Li Bing, Ji Kun, Li Tengfei, Ma Ji, Ren Jianzhuang, Duan Xuhua, Su Xinhui

机构信息

Department of Nuclear Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Interventional Radiology, Xiangzhou District People's Hospital, Xiangyang, China.

出版信息

Surg Endosc. 2025 Jul;39(7):4424-4431. doi: 10.1007/s00464-025-11806-1. Epub 2025 Jun 4.

Abstract

BACKGROUND

The trans T-tube cholangial drainage (TTCD) is a novel approach that is first reported in this study for the treatment of bile leakage at the biliary-enteric anastomosis. However, no researchers have compared it with percutaneous transhepatic cholangial drainage (PTCD) as yet.

METHODS

The clinical and imaging data of patients with bile leakage at the biliary-enteric anastomosis treated with TTCD (TTCD group) or PTCD (PTCD group) at three centers were retrospectively evaluated. The differences between the two groups in terms of surgical outcomes, perioperative complications, intraoperative radiation exposure time, and total hospitalization costs were compared.

RESULTS

There were 32 and 54 patients in the TTCD and PTCD group, respectively. No surgery-associated deaths occurred in both groups. The technical success rate was 100% in the TTCD group and 88.9% in the PTCD group (P = 0.051). Furthermore, within one week post-treatment, both groups showed a significant decrease in serum total bilirubin levels, with a greater reduction observed in the TTCD group (P < 0.05). The TTCD group had significantly less intraoperative bleeding compared to the PTCD group (P < 0.0001). In terms of surgical complications, there was a statistically significant difference in complications between the two groups (P = 0.031). Besides, the TTCD group had significantly shorter intraoperative radiation exposure time compared to the PTCD group (P < 0.0001). In addition, the TTCD group had shorter hospital stays after surgery (P < 0.0001) and lower surgical costs (P < 0.0001).

CONCLUSION

Trans T-tube cholangial drainage catheter was a safe option with improved clinical outcomes compared to traditional PTCD drainage for the treatment of bile leakage at the biliary-enteric anastomosis.

摘要

背景

经T管胆管引流术(TTCD)是本研究首次报道的用于治疗胆肠吻合口漏的新方法。然而,尚无研究人员将其与经皮经肝胆管引流术(PTCD)进行比较。

方法

回顾性评估三个中心接受TTCD(TTCD组)或PTCD(PTCD组)治疗的胆肠吻合口漏患者的临床和影像资料。比较两组在手术结果、围手术期并发症、术中辐射暴露时间和总住院费用方面的差异。

结果

TTCD组和PTCD组分别有32例和54例患者。两组均未发生与手术相关的死亡。TTCD组的技术成功率为100%,PTCD组为88.9%(P = 0.051)。此外,治疗后一周内,两组血清总胆红素水平均显著下降,TTCD组下降幅度更大(P < 0.05)。与PTCD组相比,TTCD组术中出血明显更少(P < 0.0001)。在手术并发症方面,两组之间的并发症存在统计学显著差异(P = 0.031)。此外,与PTCD组相比,TTCD组术中辐射暴露时间明显更短(P < 0.0001)。此外,TTCD组术后住院时间更短(P < 0.0001),手术费用更低(P < 0.0001)。

结论

与传统的PTCD引流相比,经T管胆管引流导管是治疗胆肠吻合口漏的一种安全选择,临床效果更佳。

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