Comparative Study On The Clinical Curative Effect Of Minimally Invasive Treatment Of Choledocholithiasis Without Cholecystolithiasis

Objective:To compare the clinical efficacies of different minimally invasive methods in the treatment of choledocholithiasis without cholecystolithiasis.Methods:he clinical data of 83 patients of choledocholithiasis without cholecystolithiasis undergoing surgical treatment in recent three years were analyzed retrospectively.Of the patients,21 cases underwent laparoscopic common bile duct exploration and preserving gallbladder(A group),25 cases underwent laparoscopic common bile duct exploration and cholecystectomy(B group),18 cases underwent laparoscopic common bile duct exploration and cholecystectomy+T tube drainage(C group),and19 cases underwent endoscopic sphincterotomy(D group).The treatment process,postoperative recovery and other related clinical indicators among the four groups were compared and analyzed.Results:A group patients were not placed in the T tube,no postoperative complications such as biliary fistula,residual stones,postoperative follow-up of more than 24 months,no recurrence of stones.Patients in group B were placed T tube after operation,1 cases of patients with biliary fistula,1 cases of patients after eighteenth months of recurrent common bile duct stones.C group patients were placed in the T tube,2 cases of postoperative patients with biliary residual stones,1 cases of patients after 24 months recurrence of hepatolithiasis.In group D,2 cases of patients suffered from mild pancreatitis,and in the other group,reflux cholangitis occurred at the end of the 1 month after operation.The recurrence of common bile duct stones was found at the end of 18 months after operation.C group had the longest hospitalization time and the operation time(P < 0.05).There was no significant difference between the 4 groups in the amount of bleeding and the total hospitalization expenses(P > 0.05).Conclusions:Treatment of 4 types of minimally invasive surgery without cholecystolithiasis in common bile duct stones have advantages and disadvantages,the individualized treatment is adopted according to the condition of patients.The laparoscopic common bile duct exploration and cholecystectomy is a safe and effective procedure for patients with common bile duct stones without cholecystolithiasis.