Comparison Of Therapeutic Effects Of Three Moods For Extrahepatic Bile Duct Stones

Cholelithiasis is a common disease and frequently occurring disease of hepatobiliary and pancreatic surgery. Recent study shows gallbladder weighs 79.9%; Extrahepatic bile duct stones with gallbladder stones weighs 9.2%; Extrahepatic bile duct stones weighs 6.2%. According to statistics, in the western countries, the incidence of gallstones is about 10%-40%, and mainly for gallbladder stones;while in eastern countries, its incidence is about 2%-6%, and in recent years, the incidence of cholelith disease showed a trend of rising. Most bile duct stone would appear clinical symptoms such as fever, abdominal pain, jaundice, severe cases of acute obstructive suppurative cholangitis, life-threatening, so the bile duct calculi patients usually need surgery. Since Phillip took the lead in the laparoscopic common bile duct incision to take stone, T tube drainage in 1991, the operation has been gradually accepted by surgeons and patients, but there is a huge loss of bile long-term T tube drainage, electrolyte disorder, prolong patient recovery time, increase patients’pain, and many other problems,. With the continuous development of minimally invasive technology and the requirements of patients to treatment, laparoscopic primary closure gradually occurred in clinical applications, but primary closure has its strict limitation. With the fulfillment of endoscopic technology, a number of national medical centers use laparoscopic, choledochoscope, and duodenumscope to solve the extrahepatic bile duct stones,which has received pretty good effects. It is very important for the comparison of the three surgical methods of extrahepatic bile duct stones.Objective:To explore the three surgical moods of extrahepatic bile duct stones:T tube drainage,primary closure and LCEPN.Materials and methods:This reseach has chosen 52 cases of choledocholithiasis patients who had accept operation treatment from 2013 October to 2015 March in our hospital. According to the operation methods, the patients were divided into 3 groups (LCBDE-T, LCBDE-PS, LCBDE-ENBD group), respectively, to compare the following results:complication incidence, the average posthospitalization days, drainage tube indwelling time, first exhaust time and postoperative recurrence rate, to evaluate the clinical efficacy of the three different kinds of operations.Result:All patients were treated with operation.There exist significant differences (P<0.05) for the complication incidence, the average posthospitalization days, drainage tube indwelling time, first exhaust time and postoperative recurrence rateConclusion:1. Compared with T-drainage,primary suture can effectively shorten the postoperative hospital stay, postoperative exhaust time and drainage time indwelling time.2. LECPN can widen the indication of primary suture.3.The surgical treatment of extrahepatic bile duct stones need to follow the principle of individualized treatment.