Clinical Data Analysis For507Cases Of Choledocholithiasis

Objective: In order to analyze the transition of the modus operandi ofcholelithiasis within10years, we did some comparison among different operationmethods of cholelithiasis by several indices in this study, including sex, age, hospitalstay, complication.Methods: Patients of cholelithiasis admitted in Dalian medical universityaffilliated hospital within16years were submitted. We formed a database includingadmission number, gender, age, hospital stay, complication, the habits of smoking ordrinking, weight, temperature before and after operation and so on. We analyzed theindices of these data, discussed the merits and drawbacks of those modus operandi, andinvestigated the transition of Therapeutic Method of cholelithiasis for further.Results:1. The age of the patient involved in our study distributed between17-92, with anaverage age of63.92±13.90. The onset age of male patient was64.40±13.96, while forfemale the data was63.39±13.84. There was no statistical significance(P>0.05).2. According to our database, the age peak of the disease onset in our hospitalwas71～80in male and61～70in female. The male has more susceptibility comparedto the female in these disease, with the ratio of1.11:13. The operation method changed in recent years, ERCP has been graduallyincreasing while Laparotomy decreasing, which induced that Laparotomy was notpreferred for cholelithiasis. However, according to our data, it still has a long way to gofor ERCP to replace Laparotomy and laparoscope.4. The patients received ERCP had a shorter hospital stay of13.73±6.73,compared to Laparotomy and laparoscope of21.88±9.69, which has statisticalsignificance(P<0.05); the success rate of Laparotomy and laparoscope was higher thanERCP; more patients received Laparotomy or laparoscope suffered from a hightemperature after operation than ERCP, all those have statistical significance(P<0.05). But the complication has no difference between these two methods(P>0.05).5. CA19-9may play an important role in the judgment of the pathologicalchanges of the obstruction of biliary system.Through the statistical analysis of507casescholelithiasis patients,we could draw a conclusion that200cases had the dataes ofCA199before operation,99cases of them were higher than normal level,with apercentation of49.5%,307patients were droped.10cases received the examination ofCA199after operation and there were497patients didn’t examine their CA199beforeor after operation.6cases in which they got their CA199result before or afteroperation,all the patients had a decreasing trend after operation,1reached to normallevel and3had an obvious drop(>300U/ml).We did statistical analysis of modusoperandi and the decreasing value through two single-sampled rank-sum test,the resultdidn’t showed us an obvious statistical discrepancy. We analyzed the level of CA199before and after operation through rank-sum test,the result showed P<0.05.This revealedthat there was an obvious difference between these two datas.Operation played a keyrole in decreasing level of CA199.Conclusion: We could draw a conclusion that the modus operandi of cholelithiasishas a transition form Laparotomy or laparoscope to ERCP, but either method couldreplace the other one based on existing data available in our hospital.