Application of combined three endoscopes nasobiliary drainage in emergent operation on choledocholithiasis

Abstract

Objective To investigate the advantage, practicability and indications of combined three endoscopes nasobiliary drainage in laparoscopic choledocholithotomy on the choledocholithiasis and acute cholangitis. Methods The clinical data of 45 choledocholithiasis patients with acute cholangitis from July 2008 to December 2014 were analyzed retrospectively. Twelve cases in the group of primary closure of common bile duct after applied nasobiliary drainage by combined three endoscopes(the study group), 33 cases in the group of T-tube drainage(the control group). All patients had undergone laparoscopic cholecystectomy and choledocholithotomy. The mean operative time, intestinal effection restored time, biliary drainage time, hospital stay, duration of tube in biliary duct placement, infection disappeared and abdominal and pelvic cavity drainage of the two groups were compared. Results In the study group, the mean operative time was (56.56±5.64)min, intestinal effection restored time was (44.43±8.46)h, biliary drainage time was (7.30±1.32)d, duration of tube in biliary duct placement was (8.28±1.32)d, infection disappeared time was (4.74±0.77)d, abdominal and pelvic cavity drainage time was (4.56±0.87)d, mean hospital stay was (9.94±1.19 )d; and those in the control group were( 40.96±6.41)min, (53.16±9.64)h, (7.38±1.24)d, (30.40±1.95)d, (4.54±0.92)d, (4.49±0.91)d and (11.12±1.73)d, respectively. To compared with the control group, intestinal effection restored time, duration of tube in biliary duct placement and hospital stay of the study group were significantly decreased(P 0.05). Nevertheless, mean operative time was significantly increased in the study group(P<0.05) Conclusions Compare with the traditional laparoscopic choledocholithotomy combined with T-tube drainage, nasobiliary drainage by combined three endoscopies is practicable in emergent operation on common bile duct calculus, which has a short duration of tube in biliary duct placement and a fast postoperative restore. Key words: Common bile duct calculus; Emergent operation; Combined three endoscopes; Nasobiliary drainage