| Objective:The advantages and disadvantages of the double-mirror combined surgery were summarized by comparing the surgical procedure and postoperative comparison of common bile duct stones treated with laparoscopic choledochoscopy and conventional open surgery.Main methods:Collected 68 patients with common bile duct stones who had undergone surgical treatment in the Affiliated Hospital of Taishan Medical College from January 2013 to December 2017.According to the different surgical methods,the patients were divided into double-mirror combined group(38 cases)and In the traditional open surgery group(30 cases),the general data,relevant surgical indicators,duration of operation,intraoperative blood loss,duration of hospitalization,and postoperative venting time were statistically calculated.The data obtained from the statistics were compared and analyzed.It is proved that laparoscopic combined with choledochoscopy can achieve similar effects to open surgery in the treatment of common bile duct stones and it has fewer postoperative complications.It has advantages that can not be compared with open surgery.Results:All the patients in the two groups completed the surgery.The patients who underwent double-mirror combined surgery did not undergo conversion to laparotomy.All the patients were successfully performed under the microscope.In the selected double-mirror combined surgery group,4 patients had previous history of cholecystectomy;in the traditional open group,3 patients had previous history of cholecystectomy.All patients did not experience severe intra-abdominal hemorrhage,organ injury around the surgical site,and no deaths.There was no statistically significant difference in the male to female composition ratio and age distribution interval between the double-mirror combined group and the traditional open group(P>0.05),and they were comparable.The operation time was(203.34±51.40)min in the double-mirror combined group,(202.53±49.58)min in the traditional open group,and(30.26±21.96)ml in the double-mirror combined group.The traditional open group was(138.83 ± 63.46)ml;the average length of surgical incision in the two groups was(3.41 ± 0.29)cm in the double-mirror combined surgery group and(20.0 ± 3.5)cm in the traditional open group.Conclusion:1.The surgical minimally invasive surgery is the main direction of medical innovation.Double-mirror combined surgery for the treatment of common bile duct stones is similar to traditional open surgery compared to the effect of surgery,patients Faster recovery,less intraoperative bleeding,significantly lower postoperative pain than open surgery patients,small scars,short hospital stay,high degree of patient acceptance,etc.The clinical application value is high,it is worth popularizing and applying in the clinic.2.For a small number of patients who have had their gallbladder removed due to benign diseases and later found to have stones in the common bile duct,minimally invasive treatment should be carried out if conditions permit.,which can greatly reduce the patient’s fear of repeated laparotomy.3.The laparoscopic operation of the bile duct and the fixation of the T-tube by suturing under the microscope requires the surgeon to have higher skills in the operation of the microsurgery.The operator must have the ability to operate under the laparoscope and the operation capability of the choledochoscope.4.The number of patients enrolled in this study is small,and the follow-up time for patients after hospitalization is relatively short,and it is a single-centered study.Large-sample,multi-center,long-term clinical studies are needed to support this study.5.The clinician should select the surgical treatment plan that truly meets the patient’s condition according to the specific conditions of the patient and provide reference for individualized treatment. |
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