Curative effect of surgery and endoscopic stone extraction on bile duct stones and recurrence related factors

Abstract

Objective To investigate the curative effect and recurrence related factors of surgical and endoscopic stone extraction for bile duct stones. Methods A total of 146 patients with bile duct stones admitted to the Second Hospital of Shanxi Medical University from March 2014 to March 2018 were enrolled. They were divided into observation group and control group by random number table method, with 73 cases in each group. The observation group was given surgery treatment. The control group was given endoscopic stone extraction. The curative effects of the two groups were compared. The risk factors affecting postoperative recurrence were analyzed. Results The intraoperative blood loss, operation time, postoperative hospital stay and incidence of complication in the observation group were significantly lower than those in the control group (P all 0.05), but correlated with endoscopic stone extraction, distribution of bile duct stone, intrahepatic bile duct stenosis and residual bile duct stones (P<0.05). Multivariate logistic regression analysis found endoscopic stone extraction, distribution of bile duct stones, intrahepatic bile duct stenosis and residual bile duct stones were risk factors affecting postoperative recurrence in patients with bile duct stones (OR=1.430, 95% CI=1.077 - 1.901; OR=1.342, 95%CI=1.036 - 1.738; OR=1.758, 95%CI=1.105 - 2.797; OR = 1.436, 95%CI=1.052 - 1.961, P<0.05). Conclusions The curative effect of surgical treatment on bile duct stones is better than that of endoscopic stone extraction. The endoscopic stone extraction, distribution of bile duct stones, intrahepatic bile duct stenosis and residual bile duct stones are risk factors affecting postoperative recurrence in patients with bile duct stones. The preventive measures can be implemented for the above factors clinically to promote the better recovery of patients with bile duct stones and reduce the incidence of postoperative recurrence. Key words: Surgery; Endoscopic stone extraction; Bile duct stones; Curative effect; Recurrence