The Comparative Study Between The Combined Appliances Of Three Endoscopies And Open Cholecystectomy And Open Choledocholithotomy For The Treatment Of Cholecystolithiasis And Extrahepatic Bile Duct Stones

Objective:To compare the effect of the combined appliances of three endoscopies (LC+EST/fiber choledochoscope) with which of traditional open cholecystectomy and open choledocholithotomy T-tube drainage (OC+OCHTD), to investigate the value of two or three endoscopes association for the treatment of cholecystolithiasis and extrahepatic bile duct stones.Methods:The clinical data of 266 patients of our hospital underwent cholecystolithiasis and extrahepatic bile duct stones were retrospectively analyzed from January 2003 to September 2007.They were separated 3 groups by different operative ways. 100 patients were treated with endoscopic sphincterotomy and laparoscopic cholecystectomy (EST+LC) in group EST+LC, 13 patients were treated with laparoscopic cholecystectomy and laparoscopic choledocholithotomy T-tube drainage/laparoscopic common bile duct exploration (LC+LCHTD/LCBDE) in group LC+LCHTD,and 153 patients were treated with open cholecystectomy and open choledocholithotomy T-tube drainage (OC+OCHTD).The clinical date of three groups was contrasted in the rate of success of operation,incidence of postoperative complications, incidence of reliquus calculus, fasting time, time of defecation after operation, time of hospitalization and time of postoperative hospitalization.Results:There were no statistical difference in the rate of success of operation and incidence of postoperative complications between group EST+LC and group OC+OCHTD(P>0.05),but the fasting time, time of defecation after operation, time of hospitalization and time of postoperative hospitalization between two groups were significant in statistics(P<0.01). There were statistical difference in the rate of success of operation between group LC+LCHTD and group OC+OCHTD(P<0.05),but the incidence of postoperative complications,time of defecation after operation, time of hospitalization and time of postoperative hospitalization have no statistical difference (P>0.05);The fasting time between two groups was significant in statistics(P<0.01). Conclusions: EST combined with LC is safe,effective,feasible for the treatment of cholecystolithiasis and extrahepatic bile duct stones.Compared with open cholecystectomy and open choledocholithotimy T-tube drainage, the rate of success of operation and incidence of postoperative complications have no statistical difference,but it can short remarkably the recovery time of gastroenteric function, time of hospitalization. LCBDE brings out an positive effect.They can be have an increasingly wide utilization in hospitals with compatively better conditions.