Analysis of the curative effect of laparoscopic primary suture of common bile duct with two choledocholithotomy routes

Abstract

Objective: To investigate the clinical efficacy of laparoscopic choledocholithotomy through cystic duct and common bile duct in the treatment of choledocholithiasis combined with cholecystolithiasis. Methods: 58 patients with choledocholithiasis complicated with cholecystolithiasis were selected. 26 cases were treated with choledocholithotomy through cystic duct approach and 32 cases were treated with direct choledocholithotomy. Laparoscopic combined choledochoscope or laparoscopic combined choledochoscope and duodenoscopy were performed with one-stage suture at the same time. The intraoperative diameter of common bile duct, duration of surgery, intraoperative blood loss, and length of hospital stay, drainage volume of abdominal drainage tube on the first day after surgery, extraction time of abdominal drainage tube, postoperative alanine transaminase, postoperative total bilirubin and incidence of postoperative complications were compared between the two groups. Results: Comparing the two groups of patients, the diameter of common bile duct P < 0.05 was statistically significant. The surgical time, intraoperative blood loss, hospitalization time, abdominal drainage volume on the first day after surgery, drainage tube extubation time, postoperative alanine transaminase, postoperative total bilirubin, and complication rate were not statistically significant compared with P > 0.05. Conclusion: According to the different diameter of choledocholithiasis, it is feasible to choose the appropriate path for laparoscopic primary suture of choledocholithiasis, which is worthy of further study.