The Clinical Analysis Of Est Combined With Lc In Treating Gallstone And Common Bile Duct Stones

Objective To compare the clinical effects between conformingcertain conditions combined endoscopic sphincterotomy (EST) with laparoscopic cholecystectomy (LC) and open cholecystectomy and open choledocholithotomy T-tube drainage(OC+OCHTD) under the same conditions, explore the clinical value of EST combined with LC in treating Gallstone and Common bile duct stones, summarize the technical points of this surgical and reasonable scope of application, analyse occurrence of postoperative complications.Methods Since 2000, a retrospective analysis of Ningxia Medical University Hospital and the First People's Hospital of Yinchuan City, the gallbladder and common bile duct stones in cases of elective surgery,having a clear indication for surgery, preoperative B-or MRCP examination, rule out the intrahepatic bile duct stones,common bile duct and duodenal tumors,with severe complications of acute cholecystitis and cholangitis,such as gallbladder gangrene, perforation, acute suppurative cholangitis and other,suspected gallbladder cancer,there are serious signs of peritonitis,and cirrhosis with portal hypertension are not caught out in this study。selected to meet these requirements for minimally invasive surgery EST combined LC with the same group of 300 cases of conventional cholecystectomy under the conditions of common bile duct T tube drainage of abdominal group to conduct case-control study of 300 cases ,compare the surgical bleeding,postoperative fasting time,total hospital days,success rate,the incidence of postoperative complications whether statistically significant。Results 300 cases of invasive group, 273 cases underwent surgery EST joint LC, 20 cases of abdominal transit, the surgical bleeding 60.53±20.32ml, postoperative fasting time 35.79 ±5.67h, total hospital days 6.64±1.46d, 16 cases of postoperative complications, the incidence of 5.3%。300 cases in the laparotomy group,290 cases of successful surgery Cheng , 6 cases of common bile duct exploration no stone , 4 cases of diverted cholecystectomy, common bile duct jejunum Roux-en-Y anastomosis,the surgical bleeding 90.34±13.97ml, postoperative fasting time 69.63±8.46h,total hospital days 9.23±1.78d,35 cases of postoperative complications,the incidence of 11.7%。Minimally invasive group intraoperative bleeding, postoperative fasting time, total hospitalization days and postoperative complication rate was significantly lower than laparotomy group(P<0.05),two groups of surgical success rate of surgery was no significant difference(P>0.05)。Conclusions For patients with gallbladder and common bile duct stones, Within a certain range EST joint LC technique is a really practical clinical methods, It has less trauma and rapid recovery, etc,worthy of further promotion, it can partially replace the traditional surgical method。At the same time,correctly handle the perioperative period, an accurate assessment of preoperative, Surgery should be strictly in accordance with techniques of operational,it is the key that ensure the success of the operation。...