Comparison of effects between laparoscopy and traditional open cholecystectomy in combination with common bile duct exploration for cholecystolithiasis and choledocholithiasis

Abstract

Objective To compare the effects between laparoscopy and traditional open cholecystectomy in combination with common bile duct exploration for cholecystolithiasis and choledocholithiasis. Methods A total of 200 patients with cholecystolithiasis complicated with choledocholithiasis admitted to Jinzhong Hospital of Traditional Chinese Medicine from July 2015 to February 2017 were selected as research subjects. Of them, 100 patients who received traditional open cholecystectomy combined with common bile duct exploration were enrolled in control group, and 100 patients who underwent laparoscopy combined choledochoscopic common bile duct exploration were enrolled in observation group. The stone removal rate, follow-up recurrence rate at one year after operation, surgical status, liver function indexes and incidence of complications were compared between the two groups. Results The choledocholithiasis was successfully removed in the two groups with stone removal rate of 100%; after 1 year of follow-up, the recurrence rate of stone was 2.00% in observation group and 3.00% in control group, and there was no statistically significant difference in stone clearance rate or recurrence rate between the two groups (P>0.05). The operative time, intraoperative blood loss, postoperative anal exhaust time, postoperative ambulation time and total hospital stay in observation group were shorter than those in control group (P<0.05). After treatment, the levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT) and total bilirubin (TBIL) and aspartate aminotransferase (AST) in observation group were lower than those in control group (P<0.05). The incidence of postoperative complications in observation group was lower than that in control group (7.00% vs. 23.00%), P<0.05. Conclusions Compared with open cholecystectomy combined with common bile duct exploration, laparoscopy combined with common bile duct exploration for cholecystolithiasis and choledocholithiasis has less trauma, fewer postoperative complications, and less damage to liver function, so it is safe and reliable. Key words: Laparoscopic; Open cholecystectomy; Common bile duct exploration; Cholecystolithiasis