The Application Of LC+CBDE And EST+LC In Extrahepatic Bile Duct Stones

Objective: To compare LC+LCBDE with EST+LC two methods in the treatmentof cholecystolithiasis and bile duct stones than short-term postoperative complications(1years after discharge within the risk), and further discusses the application ofLC+LCBDE and EST+LC two kinds of operation in the extrahepatic bile duct stones.Methods: a retrospective analysis of China Japan Union Hospital of JilinUniversity (including the Nan Hu district and the Xin Min district) LC+LCBDE andEST+LC2010-2013from two methods in the treatment of143cases ofcholecystolithiasis combined with bile duct stones, on short term postoperativecomplications (within1year after discharge; postoperative hyperamylasemia,postoperative acute pancreatitis, biliary infection, biliary hemorrhage, postoperativedigestive tract perforation in5aspects) was concluded according to the statisticalresults, in discussing the advantages and disadvantages of two methods, combinedwith statistical results, the result difference reasons were discussed, further discussesthe application of two kinds of operation mode of LC+LCBDE and EST+LC in thetreatment of gallbladder stones and common bile duct stones.Results: LC+LCBDE group and EST+LC group data by t test and chi square test,in the postoperative hyperamylasemia, two groups after operation of acute pancreatitis,short-term postoperative infection of biliary tract data p<0.05, the difference hasstatistical significance. The data of the two groups in the postoperative hemobiliacomparative statistical analysis p<0.05, no significant difference in the change ofliver function, LC+LCBDE group and EST+LC group after surgery, preoperative andpostoperative data of the two groups by statistical comparison of p>0.05, nosignificant statistical difference.Conclusion: in the postoperative hyperamylasemia, acute pancreatitis and biliaryinfection rate on short-term, LC+LCBDE lower than EST+LC; Oddi sphincterfunction impairment and retrograde infection of biliary tract, retain the function ofsphincter of Oddi can reduce biliary infection bile dynamics change caused by; Shi operation transpapillary process during EST stimulation pancreatic duct and ESThyperamylasemia and acute pancreatitis; in accordance with the operation ofcholecystolithiasis and bile duct stones patients, can tolerate the operation,especially in young patients, should retain the function of sphincter of Oddi in orderto reduce the occurrence of retrograde biliary infection in patients, it should be basedon the LC+LCBDE is the first choice for operation; unable to tolerate a long timeoperation in elderly patients and patients with high operation risk, should try toshorten the operation time, EST+LC can be used as a safe and effective method, topancreatic duct stimulation surgery should be reduced as far as possible to thesphincter of Oddi damage and stone extraction process.