Efficacy analysis of laparoscopy, choledochoscopy and gastroscopy in the treatment of gallstones with common bile duct stones
MA Liang-liang，SHEN Jian-wei，ZHANG Chun-yan
Abstract:
Objective To explore the clinical application value of laparoscopy, choledochoscopy and gastroscopy in the treatment of gallstones with choledocholithiasis. Methods The clinical data of 137 patients with cholecystolithiasis combined with choledocholithiasis who were treated in the general surgery department of Tianjin Fifth Central Hospital from January 2019 to December 2021 were retrospectively analyzed. According to the surgical methods, the patients were divided into three groups: observation group, control group 1 and control group 2. The observation group was treated with laparoscopic cholecystectomy, choledochoscopy and gastroscope combined with cholecystectomy, bile duct exploration and stone extraction + BD tube drainage + primary suture of bile duct, while the control group 1 was treated with laparoscopic cholecystectomy + choledochoscopy exploration and stone extraction+T tube drainage; The ERCP bile duct stone extraction + LC cholecystectomy were performed in control group 2. Three groups of relevant clinical indicators were analyzed statistically. Results There was no statistical differences in operation time, intraoperative blood loss and the postoperative abdominal catheterization time among the three groups (P> 0.05). The T-tube, hospitalization time and hospitalization cost were better than those in the control group (P<0.05). The complications such as abdominal infection, hemorrhage, biliary fistula and sinus rupture in the observation group were less than those in the control group, with statistical difference (P<0.05). Conclusion For gallstones with choledochal stone patients, through the treatment of laparoscopy, choledochoscope, gastroscope combined cholecystectomy + bile duct exploration stone + BD tube drainage + bile duct primary suture can significantly improve the therapeutic effect, patient pain, low postoperative complications, also can effectively reduce the hospital time and hospitalization costs, which has a good clinical application value.
