Three Kinds Of Surgical Treatment Of Gallbladder Stone With Common Bile Duct Calculi Clinical Comparative Analysis

Objective:Extrahepatic bile duct stone is a kind of common and frequently-occurring disease in general surgery. As the development of laparoscopy, choledocholscope and endoscopic retrograde cholangio-pancreatography (ERCP), the minimally-invasive therapy has been improved quickly. This study is to explore the effective treatment by observing the clinical curative effect, including the amout of bleeding during operation, recovery time of gastrointestin function after operation, operation time, hemodiastase, and time and cost of hospitalization.Method:To summarize76cases of choledocholithiasis patients who were treated with different combinations of laparoscopy and choledochoscope randomly in the Shanxi Provincial People’s Hospital from October,2010to November,2011. All patients were separated3groups by different operative ways.20patients were treated with traditional open cholecystectomy and open choledocholithotomy T-tube drainage (Group A),24patients were treated with laparoscopy and choledochoscopy (Group B), and another32patients were treated with laparoscopy and ERCP (Group C).The success rate of operation, the amout of bleeding, operation time, fasting time, incidence of postoperative complications (the value of hemodiastase one day after operation (mean value0-85IU/L) and incision infection), fastiong time, time of defecation after operation, time of hospitalization and time of postoperative hospitalization were observed and recorded.Results:There was no statistical significance in the success rate of operations among there groups(P>0.05). Compared with Group A, in Group B and group C, amout of bleeding、time of operation, fasting time, time of defecation after operation, and time of postoperative hospitalization decreased significantly (P<0.05). The cost of hospitalization in Group B was less than Group A and C (P<0.05), while there was no significant difference between Group A and group C (P>0.05). The Incidence of postoperative complications in Group B is the lowest, and there was no significant difference between Group A and group C (P>0.05). The complication is mainly incision infection in Group A, while abnormal increase of serum-amylase in Group C.Conclusio:Compared with the traditional open operation, combination of laparoscopy and choledochoscopy is an effective and safe operation to treat. It can decrease the amout of bleeding, shorten operation time and recovery time of gastrointestin function after operation, decrease complication of postoperation time of hospitalization and cost.