Clinical analysis of different treatment options for cholecysto-choledocholithiasis

Abstract

Objective To evaluate the efficacy of different treatment options for cholecysto-choledocholithiasis (CCL), and try to find the ideal treatment. Methods From January 2006 to January 2016, a total of 3 107 patients with CCL from the Affiliated Hospital of Inner Mongolia Medical University were enrolled. Among them, 1 283 patients were in open cholecystectomy (OC) and open common bile duct exploration (OCBDE) group, 964 patients were in laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) group, and 860 patients were in endoscopic retrograde cholangiopancreatography (ERCP)+ LC group. The clinical data of the three groups were analysed. One-way analysis of variance and chi-square test were performed for statistical analysis. Results From 2006 to 2010, the percentage of patients treated with OC+ OCBDE, LC+ LCBDE, and ERCP+ LC were 56.05%(829/1 479), 25.15%(372/1 479) and 18.80%(278/1 479), respectively; from 2011 to 2016, the percentage of patients received the above three treatments were 27.89%(454/1 628), 36.36%(592/1 628) and 35.75%(582/1 628), respectively. The difference in the proportion of the same treatment at different times was statistically significant (χ2=4.775, 4.168 and 0.669, all P 0.05). The hospital stay of the OC+ OCBDE group, the LC+ LCBDE group and the ERCP+ LC group were (6.7±1.3) days, (5.6±1.2) days and (10.9±1.6) days, respectively, and the differences were statistically significant (F=90.010, P<0.01). The hospitalization expenses of OC+ OCBDE group, LC+ LCBDE group and ERCP+ LC group were (13 720±1 910) yuan, (18 150±1 490) yuan and (25 830±2 430) yuan, respectively, and the differences were statistically significant (F=302.991, P<0.01). Conclusion The first choice of patients with CCL is endoscopic minimally invasive treatment and open surgery can be used as a remedial method for endoscopic treatment. Key words: Cholecysto-choledocholithiasis; Endoscopic minimally invasive treatment; Open surgery