Analysis of Three Surgical Methods for Cholecystolithiasis Complicated with Extrahepatic Bile Duct Stones
XU Ming-you,YANG Xian-fen,CHEN Xi-lan
Department of Hepatobiliary Surgery，Wanbei Coal and Electricity Group General Hospital The Third Af.liated Hospital of Bengbu Medical College, Suzhou 234000, China
Abstract:
Objective According to the different characteristics of cholecystolithiasis complicated with extrahepatic bile duct stones, open cholecystectomy+common bile duct exploration (OC+OCBDE), endoscopic retrograde cholangiopancreatography+laparoscopic cholecystectomy (ERCP+LC) and laparoscopic combined choledochoscopy (LC+LCBDE) were selected to evaluate the efficacy, safety and application value of the treatment of cholecystolithiasis complicated with extrahepatic bile duct stones. Methods From May 2015 to May 2018, the clinical data of 125 patients with cholecystolithiasis complicated with extrahepatic bile duct stones treated in the Department of Hepatobiliary Surgery, General Hospital of Anhui North Coal and Electricity Group were retrospectively analyzed. The operation time, success rate, postoperative anal exhaust time, hospitalization days, hospitalization costs, stone residue rate and complication rate were compared. Results There was no significant difference in gender, age, clinical manifestation and residual stone rate between the three groups (P> 0.05). There were signi.cant differences in operation time, operation success rate, postoperative anal exhaust time, hospitalization days, total hospitalization fee, postoperative bile leakage and so on (P<0.05). There was no signi.cant difference in residual stone rate (P>0.05). Conclusion The three types of cholecystolithiasis and extrahepatic bile duct stones are all safe and effective methods for treating gallstone and extrahepatic bile duct stones. Group OC+OCBDE is a classic traditional surgical method. Although it is very traumatic, it can be used as an effective remedy for the failure of the latter two types of operation. Group ERCP+LC holds the integrity of the bile duct, and group LC+LCBDE is guaranteed. The function of the sphincter of Oiddis is protected. The surgeon should make a reasonable choice according to the patient’s individual condition, his own technology and hospital equipment conditions.
