Retrospective Clinical Study Of ERCP+LC And LC+LCBDE In The Treatment Of Gallstones Complicated With Common Bile Duct Stones

Objectives In retrospective clinical study,this paper summarizes the differences in the efficacy of ERCP+LC and LC+LCBDE minimally invasive surgery for the treatment of gallbladder stones with common bile duct stones,and their respective advantages,in the treatment of gallstones combined with common bile duct The choice of stones provides a certain reference.Methods A retrospective study was conducted to select 90 patients with gallbladder stones and common bile duct stones who were admitted to the Hebei Provincial People’s Hospital from September 2016 to October 2018,and who met the criteria for inclusion in this study.These included 60 patients who received LC+LCBDE and 30 patients who received ERCP+LC.Through statistical records and analysis,the general conditions of the two groups of patients,surgical success rate,operation time,intraoperative bleeding,hospitalization time,postoperative hospital stay,hospitalization costs and postoperative residual stones,bile leakage,bleeding,digestive tract perforation,pancreas Long-term recent complications of inflammation,biliary infection,biliary stricture,and stone recurrence.Results In general,there was no significant difference in gender,preoperative chronic disease,and liver function between the two groups(P>0.05).However,there were significant differences in age,common bile duct diameter,maximum bile duct stone diameter,and stone traits(P < 0.05).Patients in the ERCP group were younger than those in the LCBDE group;the average diameter and maximum bile duct in the ERCP group were the largest.The average diameter of bile duct stones was generally smaller than that of the LCBDE group.The proportion of sediment-like stones in the LCBDE group was significantly smaller than that in the ERCP group.Intraoperative situation: There was no significant difference in the rate of conversion between open surgery and success rate between the two groups(P>0.05),but the amount of intraoperative blood loss,postoperative indwelling drainage tube and total operation time were significantly less in the ERCP group.In the LCBDE group,the difference was statistically significant(P <0.05).Postoperative complications: The incidence of postoperative hyperamylasemia,pancreatitis,and stone residuals in the ERCP group(16.7%,10%,and 6.7%,respectively)were higher than those in the LCBDE group(1.7%,1.7%,1.7%).However,there was no significant difference in the incidence of pancreatitis and residual rate of stones(P>0.05),but the difference in the incidence of hyperamylasemia was statistically significant(P<0.05);ERCP in the incidence of postoperative bile leakage The group was lower than the LCBDE group,but the difference was not statistically significant(P>0.05).The overall complication rate was higher in the ERCP group than in the LCBDE group,but the difference was not statistically significant(P>0.05).In terms of hospitalization: The average hospital stay was similar in the ERCP group and the LCBDE group.The average hospital stay was higher in the ERCP group than in the LCBDE group,but the difference was not statistically significant(P>0.05).The average hospitalization cost of patients in the ERCP group was significantly higher than that in the LCBDE group,and the difference was statistically significant(P<0.05).Conclusions LC+LCBDE and ERCP+LC have good curative effect on gallstones combined with common bile duct stones.The effectiveness of both(surgical success rate,conversion rate,calculus residual rate,etc.)and safety(complications)The incidence wassimilar;the ERCP group had less surgical trauma and faster postoperative recovery than the LCBDE group;however,LC+LCBDE should be the first choice for patients considering economic conditions.Table4;Figure 1;Reference 102...