Comparison Of Therapeutic Effects Of Different Surgical Treatments For Recurrent Bile Duct Stones

Cholelithiasis is a common disease and frequently occurring diseaseof hepatobiliary and pancreatic surgery. With the development of medicaltechnology, more and more operation procedure is applied to thetreatment of bile duct stones. But the Cholelithiasis has residual stone rate,high rate of cholangitis and high recurrence rate, which remains a thornyproblem facing us. Exploration of common bile duct after operation andrepeated exploration of biliary tract after treatment of recurrent commonbile duct stones is difficult. For recurrent bile duct stones, the commonbile duct exploration, T tube drainage and Roux-en-choledochojejuno-stomy are two kinds of operations for long time in the hepatopancreato-biliary surgery in China. It is very important for the comparison of thetwo surgical methods of recurrent common bile duct stones.Objective: To investigate the two surgical methods of recurrentcommon bile duct stones: The common bile duct exploration, T tubedrainage and Roux-en-choledocho-jejunostomy.Materials and methods: This reseach has chosen126cases ofrecurrent choledocholithiasis patients who had accept operation treatmentfrom2008January to2011January in our hospital. According to theoperation methods and the diameter of common bile duct, the patients were divided into3groups (A, B, C group), respectively, to compare theshort-term results of perioperation period (complication incidence and theaverage hospitalization days), and long term results(postoperativerecurrence rate, cholangitis recurrence rate), to evaluate the clinicalefficacy of the two different kinds of operations.Result: All patients were treated with operation. In the common bileduct exploration, T tube drainage group (group A, B),the averagehospital stay was not significantly different from that of Roux-en-choledochojejunostomy; For the peri operation complications, group A(14.9%) and B group (18.4%) and C group (20%no significant difference(P>0.05). Long term results, the recurrence rate of hepatolithiasis afteroperation in B group (18.37%) was higher than that in group A (6.38%)and C group (6.6%).Conclusion:1. recurrent common bile duct stones with bile duct dilation, shouldadopt the Roux-en-choledochojejunostomy.2. the treatment of recurrent common bile duct stones should upholdthe personalized, systematic approach.