The Clinical Research On The Combined Three Endoscopes With Primary Closure In Treating Choledocholithiasis Associate With Cholecystolithiasis

ObjectiveTo compare the effects of the combined application of three endoscopes withprimary closure with which of traditional open cholecystectomy，to investigate thevalue of the combined application of three endoscopes with primary closurefor thetreatment of choledocholithiasis and cholecystolithiasis.MethodsFrom December2010to December2013,80patients with choledocholithiasisassociate with cholecystolithiasis in the first affiliated hospital of the traditionalChinese medicine university of hunan were recruited. These patients were randomlydivided into group L and group O,with30patients in each groups. Patients of groupL were treated with endoscopic retrograde cholangiopancreatography, endoscopicnasobibiary drainage,laparoscopic cholecystomy,laparoscopic common bile ductexploration and primary closure.Patients of group O were treated with OpenCholecystectomy and T tube drainage. Comparing the operation success rate,stone-free rate, operation time, Intraoperative blood loss and postoperativerecovery.in addition,the level of total Bilirubin,direct Bilirubin and alanineaminotransferase in serum, recovery time of gastrointestinal function, hospital-stays after the operation, postoperative complications and hospital costs were contrastedand underwent statistical analyze.Results1. The intraoperative situation: The rate of the treatment success rate of surgeryand stone clearance between group L and group O is not obvious(P>0.05);The meanoperating time of group L is longer than group O(P＜0.01); The intraoperative bloodloss of group L is obvious less than group O（P＜0.01）.2. The postoperative condition: The time of placing the abdominal cavity drainagetube between group L and group O is not o3.The postoperative complications:The postoperative complication bvious(P>0.05);The recovery time of gastrointestinal function and the hospital-stay after theoperation of group L is shorter than group O（P＜0.01）.s of group L is less than groupO（P＜0.05）.4.The hospital costs:The hospital costs of group L are more than group O（P＜0.01）ConclusionThe combined three endoscopes with primary closure is safe,effective,feasible forthe treatment of choledocholithiasis associate with cholecystolithiasis, Comparedwith open cholecystectomy,they has the advantage of high success rate of surgery andstone clearance,lighter operation response,less intraoperative blood loss, smalleraffect on visceral function,rapid postoperative recovery,shorter operation time, fewercomplications.So this operation method is a kind of therapy in treatment ofcholedocholithasis associate with cholecystolithiasis. combined three endoscopeswith primary closurebrings outan positive effect. They can be have an increasinglywide utilization in hospitals with compatively better conditions．...