| Objectives To explore the efficacy of laparoscopic cholecystectomy+common bile duct exploration and indwelling T-tube and primary suture in patients with gallbladder stones and common bile duct stones,compare the advantages and disadvantages of the two surgical methods,and provide clinicians with reference for surgical decision-making.Methods A retrospective analysis of the clinical data of patients who underwent LC+LCBDE at the Department of Hepatobiliary,Pancreatic and Splenic Surgery,Hebei General Hospital from June 2018 to June 2020.A total of 147 patients were selected,of which 15 patients were converted to laparotomy due to abdominal adhesions,stone incarceration and other reasons.Finally,clinical data of 132 patients were collected.According to the different treatment methods after common bile duct stone removal,they were divided into one-stage suture group(n=32)and T-tube drainage group(n=100).Collect patient data truly and objectively,use SPSS 24.0 software to process the data,and compare the general information,intraoperative and postoperative indicators,postoperative complications,etc.between the two groups.Results All patients successfully completed the operation.There was no significant difference in general information and preoperative complications between the two groups of patients(P>0.05).The operation time of the primary suture group was 118.50 min(110.00-140.00 min),and the operation time of the T-tube drainage group was 155.00min(121.25-182.25 min),the difference was statistically significant(P<0.05);The postoperative bowel function in the primary suture group recovered time(2.09±0.93days),the recovery time of intestinal function in the T-tube drainage group(2.65±1.13days),the difference was statistically significant(P<0.05);The postoperative hospital stay in the primary suture group was 6.00 days(6.00-8.00 days),the postoperative hospital stay in the T-tube drainage group was 12.00 days(9.00-14.00 days),the difference was statistically significant(P<0.05);The total hospitalization cost of the primary suture group was 40 thousand yuan(36.5-49.1 thousand yuan),the total hospitalization cost of the drainage group after surgery was 51.4 thousand yuan(44.2-59.2 thousand yuan),and the difference was statistically significant(P<0.05);But there was no significant difference in the amount of intraoperative blood loss and postoperative drainage tube removal time(P>0.05).In terms of postoperative complications: there was no significant difference between the two groups in postoperative complications such as bile leakage,residual choledocholithiasis,and total postoperative complications(P>0.05).After 6 to 12 months of follow-up,the patient did not have complications such as recurrence of stones or stenosis of the common bile duct.Conclusions 1 The indwelling T-tube after LC+LCBDE will cause a series of complications,and it does not reflect the advantages of laparoscopic minimally invasive surgery.2 Primary suture of the common bile duct can avoid bile outflow,promote postoperative diet recovery,reduce the patient’s hospitalization cost,shorten the hospitalization time and reduce the operation time,while not increasing the patient’s postoperative common bile duct stones,bile leakage and other biliary complications the incidence of symptoms and overall complications.3 Under the premise of strictly grasps the indications for the first-stage suture,the first-stage suture is safe and reliable,can benefit patients in the clinic,and is worthy of clinical promotion.Figure 0;Table 4;Reference 142... |
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