Comparison Of The Clinical Efficacy Of LC+LCBDE And ERCP/EST?EPBD+LC In The Treatment Of Cholecystolithiasis With Common Bile Duct Stones

Objective: To compare the therapeutic effect of laparoscopic cholecystectomy(LC)combined with laparoscopic common bile duct exploration(LCBDE)and endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy?endoscopic papillary balloon dilatation(ERCP/EST?EPBD)combined with LC two minimally invasive surgery in the treatment of cholecystolithiasis with common bile duct stones by reviewing clinical case data.Methods:The clinical data of 111 patients with cholecystolithiasis with common bile duct stones treated in the First Affiliated Hospital of Anhui Medical University from July 2014 to March 2017 were analyzed retrospectively.They were divided into LC +LCBDE minimally invasive surgery group(57 cases)and ERCP / EST,EPBD + LC minimally invasive surgery group(54 cases)according to the operation method after admission.By analyzing and comparing the preoperative general conditions and the intraoperative and postoperative clinical data of two minimally invasive surgery cases and means of testing whether there is comparable between the two groups,Then the operative success rate,operative tolerance,total operation time,intraoperative blood loss,postoperative complications,postoperative hospital stay,total cost of hospitalization / supplies and so on were compared between the two groupsResults:Comparison of LC+LCBDE minimally invasive surgery group and ERCP /EST ? EPBD+LC surgery group,the preoperative general condition,postoperative laboratory and imaging data,the difference was not statistically significant,comparable;the success rate of the operation,the difference was not statistically significant(96.5%,94.4%,P>0.05),the effectiveness of two kinds of minimally invasive surgery the type is the same;Intraoperative and postoperative complications,LC+LCBDE minimally invasive surgery group the rate of residual stones,cholangitis,pancreatitis and abdominal distension were lower than ERCP / EST,EPBD+LC group,the difference was statistically significant(P<0.05);LC + LCBDE minimally invasive surgery group was superior to ERCP / EST,EPBD + LC Minimally Invasive Surgery Group in terms of consumables cost,total cost of hospitalization,patient surgical tolerance and hospitalization time,the difference was statistically significant(P<0.05);in contrast,in bile leakage rate,ERCP / EST,EPBD+LC minimally invasive surgery group were better than LC+LCBDE surgery group,the difference was statistically significant(P<0.05).Conclusions:LC+LCBDE minimally invasive surgery in the treatment of cholecystolithiasis with common bile duct stones is the same as that of ERCP / EST and EPBD+LC minimally invasive surgery.ERCP / EST,EPBD+LC type of minimally invasive surgery has certain advantages in the incidence of serious complications such as biliary fistula,and minimally invasive surgery of LC+LCBDE type has the characteristics of good patient tolerance,small trauma,low complication rate,the total cost less,short hospitalization time,can reduce the pain of patients and reduce the economic burden of patients,can be used as a first choice.