Comparative Study Of LC Combined With ERCP In The Treatment Of Gallbladder Stones With Choledocholithiasis At The Same Time And By Stages

Objective:In this study,we aimed to compare the clinical efficacy of laparoscopic cholecystectomy(LC)+endoscopic retrograde cholangiopancreatography(ERCP)for patients with gallbladder stones(GS)and common bill dust stones(CBDS)at the same period or by stages.We also explored the feasibility of LC+intraoperative ERCP for the treatment of choledocholithiasis combined with choledocholithiasis,and observed its safety,clinical treatment effect and treatment cost.Methods:A total of 438 patients diagnosed with choledocholithiasis and choledocholithiasis were retrospectively analyzed from May 2017 to May 2020.A total of 112 patients were finally included in the study according to the inclusion and exclusion criteria.There were 63 cases in the operation group(LC+intraoperative ERCP)of the same stage and 49 cases in the operation group(LC+preoperative ERCP group)of different stages.The differences in complications,total time of two operations,surgical success rate,postoperative hospital stay,and hospitalization expenses were compared between the two groups of patients after different treatments.Results:1.There was no statistically significant difference between the two groups of patients in the average age,gender,total bilirubin,alanine aminotransferase,the presence or absence of underlying diseases,the diameter of the common bile duct,or the diameter of the largest stone(P>0.05).2.There was no significant difference between the operation time of the ERCP+LC group of the same stage(131.1±33.6min)and the group of different stages(139.1±29.7min,P>0.05).3.The total incidence of postoperative complications in the group of the same stage was 17.7%vs.the total incidence of postoperative complications in the group of different stages was 20.4%,P>0.05;the average postoperative hospital stay was(7.3±1.5)days after surgery in the group of the same stage and(12.9±2.1)days in the group of different stages,and the average postoperative hospital stay in the group of the same stage was less than that in the group of different stages(P<0.05).The total cost of hospitalization in the group of the same stage(29158±3482 yuan)was lower than that in in the group of different stages(32405±4431 yuan),and the difference was statistically significant(P<0.05).Five patients in the group of different stages had biliary colic before LC after ERCP,and there was a statistical difference(P<0.05).Conclusion:The concurrent treatment of LC combined with intraoperative ERCP is a safe and effective.Compared with the operation in the group of different stages,the effectiveness and safety of the two are equivalent.The operation group in the same stage can reduce the postoperative hospital stay and hospitalization expenses of patients.