A Comparative Study Between Holmium Laser Lithotripsy Under Laparoscope And Open Laparotomy For The Refractory Hepatolithiasis

ObjectiveTo comparatively analyze the clinical effects of holmium laser lithotripsy under laparoscope and that of open laparotomy in the treatment of cholecystolithiasis omplicated with choledocholithiasis.MethodsRetrospectively analyzed the clinical data of 62 patients from January 2005 to April 2009 suffering from cholecystolithiasis complicated with choledocholithiasis,28 patients underwent laparoscope using Holmium laser lithotripsy and 34 patients received routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy. The operating time,number of cases needed post-operative analgesia, post-operative recovery time of bowel movement, wound infection morbidity, hospital stay,cost and number of cases with post-operative residual stones of the two groups were compared respectively.ResultsAll of the operation for 62 patients were successfully performed without severe post-operative complications.Of the laparoscopic group and the open group, the operating time was 98.93±10.66 min vs 122.79±13.44 min(p<0.01), the post-operative recovery time of bowel function was 1.68±0.72 days vs 3.35±0.81 days(p<0.01), number of cases needed post-operative analgesia was 2/28 vs 23/34 (p<0.01), wound infection morbidity was 0/28 vs 7/34(p<0.05),the hospital stay was 9.07±1.70 days vs 13.18±1.49 days (p<0.01), the cost was 8295.22±641.18 yuan vs 7272.71±522.38 yuan (p<0.01), number of cases with post-operative residual stones was 2/28 vs 10/34 (p<0.05) ConclusionHolmium laser lithotripsy under laparoscope for cholecystolithiasis complicated with choledocholithiasis has the advantages of minimal invasion,quick recovery and satisfactory lithotripsy effects. It can be selected as a new therapeutic choice for the treatment of refractory hepatolithiasis stones.