Clinical Analysis About Three Operative Methods For Treatment Of Extrahepatic Bile Duct Stones

Objective:Calculus of extra hepatic bile duct is a kind of common disease.There are three kinds of treatment most widely used in the clinical for the disease at present as follows:.1.the traditional open choledocholithotomy.2.duodenal endoscopic sphincterotomy(EST).3,laparoscopy combined with choledochoscopy. Through the comparison of multiple indexes, Summary of results of the 3 different treatments of extrahepatic bile duct stones were summarized, to provide a reliable basis for the clinical work.Methods:ninety-eight patients of calculus of extra hepatic bile duct clinical data(31 cases were treated with the traditional open choledocholithotomy in group A; 45 cases were treated with duodenal endoscopic sphincterotomy(EST) in group B and 22 cases were treated with laparoscopy combined with choledochoscopy in group C)were analyzed retrospectively and the operation time,the amount of bleeding, the time of gastrointestinal function recovery, the time of hospitalization, total cost of hospitalization, complications, the success rate of operation as well as the residual stone rate were observed.Results: Compared to the Laparoscopy combined with choledochoscopy group(group C) and the traditional open operation group(group A), duodenal endoscopic sphincterotomy(EST) group(group B) showed significant difference in postoperative complication rate、success rate of operation and residual stone rate(P<0.05).The rest the two groups showed no significant difference(P>0.05). Operation time(min),there was no significant difference(P>0.05) between Laparoscope combined with choledochoscope group(128.95 + 9.26) and the traditional open operation group(131.52 + 8.15). Compared with the other two groups,endoscopic sphincterotomy group costed the shortest time(97.42 + 15.16)with significant difference(P<0.05). About the amount of bleeding(ml), there was no significant difference(P>0.05) between laparoscopic operation group(20.71 + 4.21)and EST group(14.71 + 3.93).The amount of bleeding of traditional open operation group is 104.68 + 9.99 with significantly difference(P<0.05). The time of gastrointestinal function recovery between the three groups was significantly different(P<0.05). The traditional open operation group was the longest, laparoscope combined with choledochoscope groupis middle and EST group is the shortest.The results of the total cost of hospitalization and the hospitalization time between three groups is significantly different(P<0.05) as the same to the result of the time of gastrointestinal function recovery.Conclusion: Laparoscopy combined with choledochoscopy is a new type of minimally invasive treatment of extrahepatic bile duct stones, compared with the traditional open operation in significantly reduced intraoperative blood loss, decreased the hospitalization days, total hospitalization expenses and time of gastrointestinal function recovery;And compared with endoscopic sphincterotomy, laparoscopy combined with choledochoscopy was significantly decreased in residual stone rate and postoperative complications, and improved the success rate of operation. Therefore, laparoscope combined with choledochoscope in the treatment of extrahepatic bile duct stones is a more effective and safe secure than the other two.