Analysis Of The Efficacy Of LC+LCBDE And ERCP+LC In The Treatment Of Cholecystolithiasis Combined With Choledocholithiasis

Objective:To investigate the effects of laparoscopic cholecystectomy plus laparoscopic common bile duct exploration(LC+LCBDE)and endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy(ERCP+LC)in the treatment of cholecystolithiasis combined with choledocholithiasis.Methods:Collected data of 73 patients who were hospitalized in Cangzhou People's Hospital from January 2015 to December 2018 and treated with two different surgical schemes for cholecystolithiasis combined with choledocholithiasis,41 of them underwent ERCP+LC,32 of them underwent LC + LCBDE,The indexes of operation time,blood loss,hospitalization time,postoperative exhaust time,and short-term and long-term complications after operation were compared between the two groups.Results:In the ERCP+LC group,there were 41 cases,36 cases were operated successfully(3 cases of choledocholithiasis were converted to LCBDE,and2 cases of cholecystolithiasis were converted to laparotomy),the success rate was 87.80%,in the LC+LCBDE group,there were 32 cases,28 cases were operated successfully(4 cases of portal adhesion converted to laparotomy),the success rate was 87.50%,there was no difference between the two groups.The maximum diameter of choledocholithiasis in ERCP+LC group was(0.81 ? 0.14)cm,Diameter of common bile duct(0.89 ? 0.12)cm,operation time(112.71? 17.82)min,hospitalization time(10.80? 1.43)d,hospitalization cost(55676.93 ? 5570.43)yuan,incidence of pancreatitis(17.07%);Themaximum diameter of choledocholithiasis in LC + LCBDE group was(0.91 ? 0.15)cm,Diameter of common bile duct(0.97 ? 0.15)cm,operation time(99.94 ? 12.94)min,hospitalization time(9.80 ? 1.55)d,hospitalization cost(45529.84 ? 5733.48)yuan,incidence of bile leakage(15.63%),Compared the above indexes of the two groups,P < 0.05,which was statistically significant.Conclusions:1.Both minimally invasive surgery can successfully cure cholecystolithiasis combined with choledocholithiasis.2.LC + LCBDE group is superior to ERCP + LC group in terms of Surgery time,hospitalization cost and hospitalization time,and incidence of pancreatitis.There was no difference in the long-term complications rate between the two groups.ERCP + LC treated this disease step by step,divided holistic treatment into different stages,and had less surgical damage.3.For patients with large stones,the LC+LCBDE procedure should be preferred in order to reduce the operation time and the incidence of postoperative pancreatitis as much as possible.At the same time,it avoids extra medical costs incurred by LCBDE remediation after ERCP failure..