Efficacy Analysis Of Three Different Surgical Methods For Cholecystolithiasis Complicated With Choledocholithiasis

Objective:By analyzing the clinical effect of three different minimally invasive methods in the treatment of cholecystolithiasis complicated with choledocholithiasis,the rational application of the three minimally invasive methods was explored and the curative effect of the three minimally invasive methods was discussed.Methods:Clinical data of patients admitted to our department for cholecystolithiasis complicated with common bile duct stones from May 2016 to September 2020 who underwent laparoscopic cholecystectomy(LC)+ laparoscopic common bile duct exploration(LCBDE)or transcystic duct exploration(LTCBDE)were retrospectively analyzed,According to the different surgical methods,they were divided into group A(LC+LCBDE+T tube drainage),group B(LC+LCBDE+ one-stage suture),and group C(LC+LTCBDE).The general preoperative data,surgical conditions,postoperative recovery,complications and postoperative follow-up of the three groups were analyzed and compared.Results:A total of 146 patients were collected,including 72 patients in Group A,50 patients in Group B,and 24 patients in Group C,with an average age of 53.2±13.9 years old.There was no significant difference in preoperative general data between the three groups(P > 0.05).Postoperative liver function indexes of the three groups were all decreased,and postoperative alanine aminotransferase(ALT)and albumin(ALB)showed statistically significant differences among the three groups(P < 0.05),There were significant differences in operative time,intraoperative blood loss,postoperative drainage tube removal time,postoperative exhaust time,postoperative hospitalization time and hospitalization cost among the three groups(P < 0.05).There was no significant difference in the incidence of postoperative biliary leakage,biliary tract infection,acute pancreatitis and total complications among the three groups(P > 0.05).The median postoperative follow-up time of the three groups was 28 months,and there was no significant difference in postoperative stone recurrence rate between the three groups(P > 0.05).Conclusion:1.In selected patients with cholecystolithiasis complicated with choledocholithiasis,primary suture after LCBDE was superior to T tube drainage.2.LTCBDE is as safe and effective as primary suture with higher cost performance,which is worthy of clinical promotion and application.