Caesarean Operation And Laparoscopic Combined With ERCP In Treating Cholecystolithiasis With Common Bile Duct Calculi Compared The Efficacy

Objective:To analysis of Stone clearance rate, operation time, the postoperative recovery time of laparoscopic combined ERCP and disembowelment gallbladder removal of the stones,common bile duct exploration, T tube drainage for the treatment of common bile duct stone with gallstones.Methods:88 patients who were diagnosed with common bile duct stone with gallbladder stones by general surgery department and digestive department of Heji Hospital att ached to Changzhi Medical College, from June 2012 to June 2014, divided into co ntrol group and treatment group with 44 patients in each group according to the in clusion criteria and exclusion criteria. The control group given laparotomy(After gen eral anesthesia, take the hypothesis, the on the right side of the rectus incision, ab out 10 to 12 cm in length, using cis or retrograde after removal of the gallbladder,5 ml syringe needle to identify the common bile duct, in the common bile duct s egment mouth, mouth size on the basis of bile duct stones and width size selection,use of biliary tract probe, 5 mm choledochoscope and probe the lithotomy lithoto my basket, postoperative routine indwelling abdominal cavity drainage tube and the T tube, T tube angiography after 2 weeks), laparoscopic combined treatment group given ERCP operation; The treatment group patients give laparoscopy combined ER CP(Patients in prone position first, Do duodenal papilla intubation under the persp ective of C arm machine,30% alcohol iodine sea was injected after successful intub ation tube.Clear bile duct contorts the number, width and location, probably amount,then choose the stones choose balloon expansion or papillary muscle incision accor ding to patients’ age, bile duct width, the specific shape of duodenal papilla, and pr esence of duodenal diverticulum, The specific choices are: Bile duct width < 0.8 c m and the stone is small, choose balloon expansion,Stone of bile duct width > 0.8cm or larger, choose cut duodenal papillary muscle,both need to be used at the sa me time when they have duodenal diverticulum, postoperative routine indwelling no se bile duct; After completion choose prostration Low head high, on the right side of the partial high, three hole method to cut the gallbladder,Place the abdominal ca vity drainage tube at the winslow hole according to the situations.).Compare therape utic effect of two groups through stone clearance rate, operation time and postopera tive recovery time.Results:In this case-control study,excepting the bile duct stones is too large, acute ga ngrenous cholecystisis, Mirrizi syndrome and has a history of abdominal surgery or abdominal cavity inflammation that affect the LC surgery and other factors.Operati on time and postoperative recovery time of patients in treatment group is significant ly shorter than the control group, stone clearance rate is higher than the control gr oup, difference has statistical significance(P<0.05).Conclusion:Reasonable selection of laparoscopic common bile duct stone with gallstones pa tients with ERCP therapy than traditional laparotomy calculi clearance rate higher, s horter operation time and postoperative recovery time.