Clinical Comparison Of Two Combined Minimally Invasive Surgical Procedures For The Treatment Of Cholecystolithiasis And Choledocholithiasis

Objective: To Compare the therapeutic effects of laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)and primary suture and endoscopic retrograde cholangiopancreatography(ERCP)/endoscopic sphincterotomy(EST)+LC for cholecystolithiasis combined with choledocholithiasis.Methods: A retrospective analysis for the clinical data of 82 patients with cholecystolithiasis and choledocholithiasis who have been treated in our department from January 2015 to June 2017.During this period,46 cases were treated by LC+LCBDE as Group A,and 36 cases by ERCP/EST+LC as Group B.The following items have been compared between the two groups such as operation success rate?operation hemorrhage volume?hospitalization time?hospitalization costs?operation time?recurrent rate and complication rate.Results: Among the 82 cases,there were no statistically differences in terms of incidence of postoperative complication(all P>0.05)in the above two groups.However,hospitalization time [(6.30±1.91)d vs(8.17±2.31)d,P=0.00] and its costs [(34572.33±10005.28)yuan vs(43590.10±11013.52)yuan,P=0.00] were better in group A than those in group B.Conclusion: Both LC+LCBDE and ERCP / EST+LC can be considered as safe and effective for the patients with cholecystolithiasis and choledocholithiasis;LC combined with ERCP/EST can shorten the operation time and reduce intraoperative blood loss.Meanwhile,in terms of length of stay and in-patients costs.Group B seem to be better choice.Both A and B procedures have their own advantages and disadvantages.The best individual surgery method should be rationally selected according to the patient's actual condition.