A Retrospective Comparative Analysis Of Laparoscopic And Choledochoscopy Combined With Open Surgery For Cholecystolithiasis And Choledocholithiasis

ObjectiveBy comparing the clinical effect of Intravenous Inhalation Anesthesia under laparoscopic cholecystectomy and choledocholithotomy surgery and traditional open cholecystectomy and choledocholithotomy in treatment of cholecystolithiasis and choledocholithiasis,develop more secure,more surgical patients recover quickly.MethodsFrom January 2014 to December 2016 in Tai’an Central Hospital in 87 cases of surgical treatment of cholecystolithiasis and choledocholithiasis patients as the research object,including 40 cases of laparoscopic cholecystectomy plus choledocholithotomy +T tube drainage(laparoscopic group),47 patients with gallbladder resection plus open choledocholithotomy and +T tube drainage over the same period(open group)for comparative study.In the laparoscopic group and laparotomy group in the treatment of cholecystolithiasis and choledocholithiasis preoperative examination index(common bile duct diameter,bilirubin,albumin,common bile duct stones of common bile duct stones,the average size of the number)and complications(hypertension,hyperlipidemia,diabetes,carotid plaque)cases,operation time the amount of intraoperative bleeding,postoperative recovery of independent exhaust time,total hospitalization time,postoperative common complications(biliary fistula,postoperative bleeding,incision infection,biliary obstruction),postoperative observation index(postoperative 3d albumin,bilirubin),residual calculi cases,the total cost of hospitalization were statistically analyzed.Results1.Laparoscopic surgery group(40 cases)and open surgery group(47 cases)87 cases,all successfully completed,after surgery can achieve timely and effective follow-up.Two groups of patients in age,BMI,gender,comorbidity,preoperative examination the number of cases(common bile duct diameter,bilirubin,albumin,common bile duct stone size,number of common bile duct stones)are comparable(P > 0.05).2.In operation time and intraoperative bleeding volume,laparoscopic surgery group had longer operation time and less bleeding than laparotomy group,and the difference was statistically significant(P<0.05).3.Two groups of patients to restore spontaneous exhaust time,hospitalization days contrast,laparoscopic group were less than laparotomy group,the difference was statistically significant(P<0.05).4.The common complications in the postoperative group: Laparoscopic postoperative biliary fistula in 2 cases,1 cases of postoperative bleeding,incision infection in 0 cases,0 cases of biliary obstruction,0 cases of residual stones,laparotomy group postoperative biliary fistula in 1 cases,0 cases of postoperative bleeding,incision infection in 7 cases,biliary obstruction in 0 cases,0 cases of residual stones.There was no significant difference between the two groups in biliary fistula,postoperative bleeding,biliary obstruction and residual stones(P>0.05).There were significant differences in incision infection(P<0.05).5.The observation index of two groups of patients with postoperative(postoperative 3D bilirubin,albumin,postoperative 3D average maximum temperature)comparison,no statistically significant difference(P>0.05);bilirubin albumin in laparoscopic group was higher than that of the open group,the difference was statistically significant(P<0.05);3D after the operation,the average high temperature of laparoscopic group was lower than the laparotomy group.The difference was statistically significant(P<0.05).6.In the total hospitalization expenses,there was no significant difference between the two groups(P>0.05).Conclusions1.Laparoscopic cholecystectomy+common bile duct exploration and removal of stone is safe,effective,low residual stone rate.2.Laparoscopic cholecystectomy+common bile duct exploration and stone removal surgery in a short time,postoperative recovery fast,it is worthy of clinical promotion.