Clinical Analysis Of Primary Suture And T Tube Drainage Under Laparoscope Combined With Choledochoscopy And Common Bile Duct Incision

Objective:Through the comparison of laparoscopic combined with choledochoscope choledocholithotomy and primary suture after laparoscopic combined with choledochoscope lithotomy after T tube drainage surgery two cases surgical treatment of common bile duct stones,discussed in the assessment after reasonable preoperative grasp indications under the condition that the use of laparoscopy combined with choledochoscopy choledocholithotomy and primary suture in the treatment of choledocholithiasis is safe and effective,worthy of promotion.Methods:By using the method of prospective,during the period from October 2015to October 2017 in 70 cases of common bile duct stones in patients with abdominal laparoscopic surgery Affiliated Hospital of Qinghai University admitted in our department and strict preoperative evaluation.Before the operation,the coin group was thrown,the front was the study group and the reverse was the control group.The study group was treated by laparoscopy combined with choledochoscope and choledochal choledochotomy for the primary closure of the bile duct..The study group received laparoscopy combined with choledochoscope Choledocholithotomy after bile duct suture;control group given laparoscopic joint choledochoscope choledocholithotomy and T tube drainage.Finally,through comparison and analysis of the two groups of surgical patients,postoperative,postoperative complications and so on.Results:The study group of 37 patients and 33 patients in the control group,including18 male patients and 19 female patients,the age range of 32~76 years,the large diameter range from 1.0cm to 1.9cm,and the control group including 16 male patients,17 female patients,the age range of 29~77,the common bile duct to the large diameter in the range of 1..0cm to 1.7cm.The age,sex and maximum diameter of the common bile duct in these groups were not statistically significant after randomization.(1)The liver function and nutritional status of the study group and the control group were compared by t test.All the indexes indicated:P>0.05,there was no significant difference between the two groups.(2)Compared with the control group and the control group,the duration of operation and the amount of intraoperative hemorrhage were compared with the t test.The two groups were all suggested:P>0.05,the difference was not statistically significant.(3)T test was compared between the study group and the control group,and the two groups were all indicated:P>0.05,there was no statistical difference,but the postoperative anal exhaust time(H),postoperative hospitalization time(d),postoperative recovery normal working time(d),the total hospitalization cost(ten thousand yuan)group were examined by t examination.The comparison between the two indexes showed that the P<0.05 was statistically significant,indicating that the time of anal exhaust after operation,the time of hospitalization after operation and the normal working time after operation were shorter than those of the control group,and the total cost of hospitalization was reduced.(4)In the complications,there were no biliary bleeding,bile leakage,pancreatitis,residual stone and bile duct stricture in the two groups;4 cases were added after the operation,and 0 of the bile peritonitis and T tube slipping occurred in the study group;14 cases,bile peritonitis and bile peritonitis after the operation in the control group.1cases were improved after anti-inflammatory treatment,and 1 cases of T tube slipping occurred third days after the operation.Laparoscopic exploration of+T tube resetting was given.The total incidence of complications in the study group and the control group was confirmed by X~2 test:X~2=9.1260,P=0.025,the difference was statistically significant.(5)The study group and the control group after the first day,fourth days and two weeks after the liver function and nutritional status of the t test compared,all the indicators are indicated:P>0.05,the difference is not statistically significant.Conclusion:Under suitable indications,laparoscopic combined choledochoscope choledocholithotomy and primary suture for choledocholithiasis is safe,feasible,effective and worthy of promotion.