The Clinical Study Of The Choledochoscopic Minimally Invasive Gallbladder-preserving Cholecystolithotomy

Objective To compare the complications between choledochoscopic minimally inv asive gallbladder-preserving cholecystolithotomy(CMIGPC) and laparoscopic cholecystec tomy(LC) by follow-up survey, and evaluate the treatment effect and application pros pect of CMIGPC.Method With the clinical data of 40 CMIGPC cases and 59 LC cases from Au gust 2010 to August 2014, to analyze preoperative clinical data, hospitalization days an d postoperative complications(abdominal pain, diarrhea, jaundice, choledocholithiasis) by retrospectively contrast research, using SPSS19.0 medical statistical software for statist ical analysis.Results There were no statistically significant(P>0.05) between CMIGPC and LC about gender, nationality, age, hospitalization days, clinical manifestation. There we re no statistically significant between two groups about incidence of postoperative, ab dominal pain and jaundice(P>0.05). CMIGPC group comparing with LC group is l ower incidence of postoperative diarrhea, and there were statistically significant(P<0.05).Conclusion On the premise of strictly follow the operation indication, comparing with LC group, the treatment effect of CMIGPC group is satisfactory and it has a good application prospect.Obiective To investigate the choledochoscopic minimally invasive gallbladder-preserving cholecystolithotomy(CMIGPC) for operation indicatio and risk factors of postoperative recurrence of stones, to evaluate the value of application prospect of CMIGPC.Methods With the clinical data of 46 cases from August 2010 to August 2014, according to operation indications for score sheets about CMIGPC, the group of cases can be divided into three groups-group A with 22 cases, group B with 13 cases and group C with 11 cases. we observed the changes of gallbladder contraction ratio and gallbladder wall thickness between before their surgery and after, and analysized the risk factors of recurrence of stones, using SPSS19.0 medical statistical software for statistical analysis.Results 1.There were 46 cases of surgical succeeded, 3 cases of cholecystolithiasis recurred. Variance analysis results of three groups showed that the thickness of gallbladder wall in different time were statistically significant(F=19.866,P=0.000),the thickness of gallbladder wall became smaller, but no statistical difference between the three groups. 1 month after surgery the GCR have varying degrees of lower, but 3 month after surgery the GCR gradually increased, and there were statistically significant in different time(F=62.266,P=0.000). A groups of GCR on average was higher than that of group B and C(P<0.05), and the GCR among there groups and with time interaction effect are both statistically significant(F=3.946,P=0.020).Conclusion 1. The calculi recurrence rate of CMIGPC had correlation with family history, hyperlipidemia, and reduction of gallbladder function. 2. The operation indications score sheets for CMIGPC have good feasibility and practicability in cases of preoperative screening, and score A more suitable for CMIGPC. It can be a scientific forecasting of changes of gallbladder function after CMIGPC, therefore it is worth popularization and application.