Clinical Effect Of Laparoscopy Combined With Choledochoscopy Gallbladder Preserving Cholecystolithotomy For Cholecystolithiasis

Objective:By comparing the clinical indexes of laparoscopy combined with choledochoscopy gallbladder preserving cholecystolithotomy(double-endoscope combined gallbladder-preserving cholelithotomy)and laparoscopic cholecystectomy(LC),the therapeutic effect of laparoscopy combined with choledochoscopy gallbladder preserving cholecystolithotomy for patients with cholecystolithiasis was studied and analyzed.Methods:A total of 62 patients with cholecystolithiasis who were admitted to Changsha Hospital Affiliated to Hunan Normal University and underwent surgical treatment from January 2019 to December 2020 were collected and divided into two groups according to different surgical methods: the double-lens gallblade-preserving cholecystectomy group(30 cases)and the cholecystectomy group(32 cases).Compare two groups of patients with blood biochemical indexes before and after surgery,including white blood cell count(WBC),neutrophil percentage(NEU %),blood glucose,C-reactive protein(CRP),surgical complications(biliary hemorrhage,bile leakage and bile duct injury,gastrointestinal injury,infection of incision,diarrhea,abdominal pain,dyspepsia,common bile duct stones,gallbladder and colon cancer,incidence,Gastrointestinal quality of life index(GLQI)score before and 3 months after surgery.Results:The operation was carried out successfully in both groups,and there was no transfer to laparotomy.There were no statistically significant differences in general conditions(gender,age,clinical manifestations),preoperative blood biochemical indexes(WBC,NEU%,blood glucose,CRP)and preoperative GLQI scores between the two groups(P>0.05).Compared with preoperation,the levels of WBC,NEU%,blood glucose and CRP of patients in both groups increased at postoperative day2,and the increase rates of WBC,NEU%,blood glucose and CRP in the double-lens gallblade-preserving cholecystectomy group were lower than those in the cholecystectomy group(P<0.05).There was no significant difference in the incidence of total surgical complications between the two groups(P>0.05).GLQI scores 3 months after surgery in both groups were higher than those before surgery,and the postoperative GLQI scores in the double-lens gallblade-preserving cholecystectomy group were higher than those in the cholecystectomy group(P<0.05).Conclusion:The treatment of patients with gallbladder stones by double-endoscope combined gallbladder-preserving cholelithotomy can reduce the postoperative stress reaction,preserve the gallbladder function of patients and improve the postoperative quality of life.It has clinical application value and can be used as an alternative surgical method for patients with gallbladder stones.