Clinical Investigation Of AOSC Combined With Extrahepatic Bile Duct Stones Treated With ENBD And LCBDE With One-stage Suture

Objectives:To investigate the efficacy of clinical duodenoscopic nasobiliary drainage(ENBD)and laparoscopic common bile duct exploration(LCBDE)with one-stage bile duct suturing and T-tube placement for the treatment of acute obstructive septic cholangitis caused by extrahepatic bile duct stones.Methods:In 81 patients with acute obstructive septic cholangitis caused by extrahepatic bile duct stones,all of them underwent duodenoscopic nasal catheter drainage in the emergency department.Nasobiliary drainage was successful in all cases,Elective laparoscopic cholecystectomy and laparoscopic common bile duct exploration and lithotripsy will be performed after the disease stabilizes,All patients were randomly divided into two groups,A and B.Forty-one patients in group A:the common bile duct was sutured in one stage;Forty patients in group B:a T-tube was placed for drainage.Results:The intraoperative bleeding,postoperative drainage time,and postoperative bile leak rate were not statistically significant in groups A and B(p>0.05),while group B was more advantageous in terms of operation time,gastrointestinal function recovery,and postoperative hospitalization time(p>0.05),One patient in group B had a small,transient postoperative bile leak,which was cured by abdominal drainage and anti-infection,while no bile leak occurred in group A.Conclusions:Under the premise of meeting the criteria of nadir discharge and surgical indications,extrahepatic bile duct stones treated with ENBD and LCBDE and one-stage suturing for AOSC are feasible,safe and effective,and have many advantages such as not leaving the T-tube,but individualized treatment should be emphasized according to the patient’s specific situation.