Comparison Of Clinical Effect Of Two Minimally Invasive Procedure In The Treantment Of Gallstones Complicated By Common Bile Duct Stones

Objective: To investigate the clinical effect of laparoscopic common bile duct exploration(LCBDE)combined with laparoscopic cholecystectomy(LC)versus endoscopic retrograde cholangiopancreatography(ERCP)endoscopic sphincterotomy(ES T)combined with LC in the treatment of gallstones and common bile duct stones.Methods: A retrospective analysis was performed for the clinical data of 87 patients with gallstones complicated by common bile duct stones who underwent minimally invasive surgeries in The Second Affiliated Hospital of Xinjiang Medical University from December 2013 to December 2016.Among the patients,36 were treated by LCBDE+LC and 51 were treated by ERCP/EST+LC.The cilinical data including success rate of operation,rate of convertion,time of operation,time to passage of gas by anus,length of hospital stay,hospital costs and postoperative complication were compared between these two groups.The t test was used for comparison of continuous data and 2? test was used for comparison of enumerationata between groups.Results: Of all patients in the LCBDE+LC group,33(91.67%)underwent a successful surgery and 3(8.35%)were converted to laparotomy;3 patients experienenced bile leakage after surgery.Of all patient in the ERCP/EST+LC group,47(92.16%)underwent a successful surgery and 4(7.84%)were converted to laparotomy;9 patients experienced pancreatitisand 3 experienced bleeding after surgery.The incidence of acutepancreatitis of ERCP/EST+LC group is higher than LC+LCBDE group,and the difference were statistically significant(P<0.05).on the other hand,there are nosignificant differencein the rate of complication(bleeding,bile leakage)(P>0.05).Compared with the ERCP/EST+LC group,the LCBDE+LC grouphad significantly shorter time of operation and length of hospital stay and significantly lower hospital costs(P<0.05).Conclusion: Both LCBDE+LC and ER CP/EST+LC are effective minimally invasivetherapies for gallstones complicated by common bile duct stones.LCBDE+LC also has shorter time of operation,shorter hospital stay and lower hospital costs.LCBDE+LC is the first choice for inancially difficult patients.However,patient's condition,operator's expertise and local resources should be taken into account in makingtreatment decisions.