The Clinical Study Of Treatment Of Secondary Choledocholithiasis

Objectives:To evaluate the clinical outcome of the different approach of treatment for the secondary choledocholithiasis.Methods:The clinical data of102cases which had secondary choledocholithiasis was retrospectively analyzed from January2010to December2011. The micro-invasive group had44cases including25cases of LCBDE and19cases of EST+LC. The open choledocholithotomy with T-tube drainage (OCHTD) had58cases.Results:The micro-invasive was performed successfully on44cases. The number of stones in the common bile duct stones of the LCBDE group (2.42) was more than that of EST+LC (1.22)(P=0.031). The complication occurrence of micro-invasive operation group (20.5%) was significantly lower than that of OCHTD group (55.2%)(P＜0.001). The occurrence of postoperative pain in micro-invasive operation group (18.2%) was significantly lower than that in OCHTD group (68.9%)(P＜0.001). There was no statistical difference (P=0.057) in operative time micro-invasive operation group and OCHTD group (88.07±24.76min Vs101.17±43.33min). The gastrointestinal tract function recovered significantly faster in LCBDE group (27.50h) than OCHTD group (51.10h)(P＜0.001). The time of abdominal drainage after operation of LCBDE group (4.25d) was significantly shorter than that of T-tube drainage of OCHTD group (7.41d)(P＜0.001). The median postoperative hospitalization stays of micro-invasive operation group (8d) was significantly shorter than that of OCHTD group (13.74d).(P＜0.001).Conclusion:Both LCBDE and EST+LC were safe and reliable procedures. These procedures have low rate of complications, imply a shorter postoperative stay, and offer the patients more comfortable postoperative period than OCHTD. They are ideal procedure for treating patients with Secondary Choledocholithiasis.