The Clinical Research On The Combined Three Endoscopes With Primary Closure In Treating Choledocholithiasis Associate With Cholecystolithiasis

Objective:This study by observing the abdominal cavity drainage tube placement time,postoperative hospital stay,operation cost,bile leakage,acute pancreatitis,the recovery of liver function and so on many levels of residual calculi index,analysis of three kinds of treatment of gallbladder stone with common bile duct calculi minimally invasive way:laparoscopic cholecystectomy + common bile duct exploration + T tube drainage,laparoscopic gallbladder excision + + a period suture,laparoscopic common bile duct exploration-joint choledochoscope duodenum mirror issue of suture technique.Discuss the above three kinds of minimally invasive surgery in the treatment of gallbladder stone with common bile duct calculi in the clinical treatment effect and their respective advantages and disadvantages,so as to clinical doctors treatment of gallbladder stone with bravery manager provide reference and basis for the optimal operation method choice.Methods:A total of 133 patients with gallstone combined with choledocholithiasis were collected from the second affiliated hospital of kunming medical university from October 2015 to December 2017.The surgical methods were divided into three groups(group A):49 cases(group B),42 cases(group B),and 42 cases(group C).Line group A laparoscopic cholecystectomy + bile duct exploration,T tube drainage,group B + common bile duct exploration laparoscopic cystic resection plus A suture line,group C laparoscopic-joint choledochoscope duodenum mirror issue of suture technique.The general clinical data of the three groups were compared and analyzed,including gender,age,diameter of choledochal,number of stones,and preoperative liver function,to determine whether there was comparability between the groups.Then,the postoperative complications such as placement time,postoperative hospitalization time,operation cost,postoperative biliary leakage,pancreatitis and residual stones were analyzed.Results:(1)The general clinical data through the statistical analysis of three groups of cases in gender,age,common bile duct diameter,number of stone,stone diameter and preoperative has no significant difference in liver function(P>0.05),shows that from the point of general clinical data,comparable between groups.(2)Postoperative conditions:postoperative hepatic drainage time and postoperative hospitalization in group B and group C were significantly shorter than group A(P<0.05).However,there was no significant difference between group B and group C in postoperative hepatic drainage and postoperative hospital stay.(3)Postoperative complications:three groups of cases of bile leakage after surgery,acute pancreatitis,stone residues and total hair faces more incidence of complications,according to the results of A and B there was no significant difference between the two groups(P>0.05)and the group C and group A and group C and group B had obvious statistical significance(P<0.05).(4)Hospitalization expenses:the operation cost of group C was significantly higher than that of group A and B,and the difference was significant(P<0.05).There was no significant difference between group A and group B(P>0.05).Conclusion:In this study included cases,through compared to the three different minimally invasive surgery,laparoscopic-choledochoscope joint for the treatment of duodenum mirror issue of suture gallbladder stone with the clinical curative effect of bravery manager is clear,is safe and feasible,shorten the time,length of hospital stay,postoperative drainage reduced the occurrence of postoperative complications.Have all kinds of hardware and software,and strict operation indications and operation skills,three mirror joint issue of suture technique can be used as the preferred operation for treatment of gallbladder stone with common bile duct calculi,worth clinical promotion.