Analysis of 98 cases of laparoscopic cholecystectomy combined with common bile duct exploration

Abstract

Objective To explore the clinical effects of laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) on elderly patients with cholecystolithiasis and common bile duct stones. Methods 98 cases of elderly patients with cholecystolithiasis and common bile duct stones treated in our hospital from January 2012 to December 2016 were given the prospective study, and they were randomly divided into the LCBDE+ LC group (n=49) and the ERCP/EST+ LC group (n=49). The LCBDE+ LC group was given the LCBDE+ LC treatment, and the ERCP/EST+ LC group was given the endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy (ERCP/EST) combined with LC treatment. The SPSS 21.0 was used for statistical analysis, and the success rate of operation, the residual stone rate and the incidence rate of complications were compared between groups by chi-square test analysis, and the intraoperative and postoperative indexes of the measurement data were expressed by mean±standard deviation, and the t test was used for comparison between groups, and the P<0.05 showed that the difference was statistically significant. Results There was no significant difference in the success rate of surgery and the residual stone ratebetween the LCBDE+ LC group and the ERCP/EST+ LC group (P>0.05), which showed that the two operation methods could have equivalent effects. The intraoperative and postoperative indexes in the LCBDE+ LC group were significantly better than those in the ERCP/EST+ LC group such as shorter operative time, less bleeding and lower operation cost (P<0.05). The incidence rate of postoperative complications in the LCBDE+ LC group was lower than that in the ERCP/EST+ LC group, which indicated that the operation safety was higher in the LCBDE+ LC group (P<0.05). Conclusions The LCBDE+ LC and ERCP/EST+ LC have equivalent clinical efficacy in the treatment of elderly patients with cholecystolithiasis and common bile duct stones, but the LCBDE+ LC have bettter safety, shorter operative time, less bleeding and lower operation cost and incidence rate of postoperative complications, which can be used as one of the preferred method for clinical treatment of senile cholecystolithiasis with common bile duct stones. Key words: Cholecystolithiasis; Cholecystectomy, Laparoscopic; Cholangiopancreatography, Endoscopic Retrograde; Sphincterotomy, Endoscopic