Clinical effect of duodenoscopy, laparoscopy and choledochoscopy combined with cholecystectomy and common bile duct exploration in treatment of acute purulent cholangitis: a report of 48 cases

Abstract

Objective To investigate clinical effects of the duodenoscopy, laparoscopy, and choledochoscopy combined with cholecystectomy and common bile duct exploration in treatment of acute purulent cholangitis (APC). Methods Ninety-six cases of APC were randomly divided into endoscopic surgery group (48 cases) and open surgery group (48 cases). Endoscopic group underwent duodenoscopy, laparoscopy, and choledochoscopy combined with cholecystectomy and common bile duct exploration, and open group underwent cholecystectomy and common bile duct exploration in treatment. Operation time, amount of bleeding, anal exhaust time, hospital stay, pre- and post-operative DBIL, ALT, WBC, ALB, CHE level and complications of the two groups were observed. Results In the observation group, the amount of bleeding, anal exhaust time and hospital stay were significantly lower than those in control group (P<0.05). One week after operation, DBIL, ALT, WBC levels of endoscopic surgery group were significantly lower than those in the open surgery group; ALB and CHE levels were significantly increased compared with the control group (P<0.05). A 9- to 12-month follow-up found out that in the endoscopic group, the incidence of postoperative complications was significantly lower than the control group (2.08% vs 14.58%)(P<0.05). Conclusions Duodenoscopy, laparoscopy, and choledochoscopy combined with cholecystectomy and common bile duct exploration in treatment of APC is safe and effective with less trauma, less postoperative complications, quick recovery. It can effectively reduce the bleeding volume during operation, shorten hospitalization time, improve the quality of life, and fully improve the prognosis. Key words: Acute purulent cholangitis; Duodenoscopy; Laparoscopy; Choledochoscopy