Laparoscope, choledochoscope and duodenoscope combined with minimally invasive operation in the treatment of extrahepatic bile duct stones

Abstract

Objective To investigate the clinical effect of laparoscope, choledochoscope and duodenoscope combined with minimally invasive operation on extrahepatic bile duct stones. Methods A total of 120 patients with extrahepatic bile duct stones were divided according to different operation methods. Forty-four patients treated by laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) were included into the LC+ LCBDE group, 37 patients treated by endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilatation (EPBD) combined with LC were included into the EST/EPBD+ LC group, 39 patients treated by EST or EPBD were included into the EST/EPBD group. The state of stone removal and incidence of complications in the three groups were observed, and the operation associated indexes were compared. Results Among the 120 patients, 115 patients received minimally invasive operation. The stone clearance rates in LC+ LCBDE group, EST/EPBD+ LC group and EST/EPBD group were 97.73% (43/44), 94.59%(94.59) and 97.87% (37/39) respectively. There was only 1 case of complication in LC+ LCBDE group and 1 case in EST/EPBD+ LC group, and there was no complication in EST/EPBD group. There was no significant difference in stone clearance rate or the incidence of complications among the three groups (P>0.05). The operation time, hospitalization time and hospitalization cost in EST/EPBD group were significantly shorter and less than those in LC+ LCBDE group and EST/EPBD+ LC group (P<0.05). Conclusions Laparoscope, choledochoscope and duodenoscope combined with minimally invasive operation are effective on extrahepatic bile duct stones. The appropriate operation should be chosen according to the indications. Key words: Extrahepatic bile duct stones; Minimally invasive operation; Choledochoscope; Laparoscope; Duodenoscope