Clinical Efficacy Analysis Of Laparoscopic Choledocholithiasis With Emergency Diagnosis For Choledocholithiasis

Objective: Choledocholithiasis is the most common biliary system disease.And operation is the primary treatment for choledocholithiasis accompanied with acute cholangitis.With the development and maturity of laparoscopy,the accumulation and improvement of surgical skills of the surgeons and the improvement of laparoscopic equipment,for the patients underwent elective surgery,Laparoscopic Common Bile Duct Exploration(LCBDE)is an effective method for the treatment of choledocholithiasis.However,whether to operate emergent Laparoscopic Common Bile Duct Exploration for patients with choledocholithiasis accompanied with acute cholangitis is controversial.The purpose of this article is to analyze the clinical effectiveness of emergent Laparoscopic Common Bile Duct Exploration for patients with choledocholith accompanied with Acute Cholangitis.Method:The clinical data of the 188 patients underwent Laparoscopic Common Bile Duct Exploration in The Fourth Affiliated Hospital of China Medical University from Sep,2014 to Mar,2017 were retrospectively analyzed.And 82 cases who underwent emergent Laparoscopic Common Bile Duct Exploration(LCBDE)were divided into the emergent operation group,among whom the patients accompanied with acute severe cholangitis underwent Percutaneous Transhepatic Cholangial Drainage(PTCD)were excluded.All the patients suffered from mild or moderate Acute Cholangitis,and40 males and 42 females were included.106 cases who underwent elective Laparoscopic Common Bile Duct Exploration(LCBDE)were divided into the elective operation group,and 42 males and 64 females were included.The surgical time,the bleeding volume of the operation,the incidence rate of retained bile duct stone,the anus exhaust time,the hospitalization time,the hospitalization expenses,the occurrence rate of conversion to laparotomy and other related postoperative complications(biliary tract bleeding,bile leakage,pulmonary infection and ileus)of the two groups were investigated and compared.Results: Comparing the surgical time,the incidence rate of retained bile duct stone,the hospitalization time,the hospitalization expenses,the occurrence rate of conversion to laparotomy and other related postoperative complications between the common group and the emergent group,it revealed that there were no significant difference(P>0.05).However,there was a significant increase in the bleeding volume in the emergency group compared with those in the two groups.The results showed that the difference was statistically significant(P < 0.05).Conclusion: Implementing the Acute Cholangitis grading strictly,mastering the surgical indications reasonably and choosing operation opportunity properly in the clinical work,treating patients with choledocholithiasis accompanied with mild or moderate Acute Cholangitis with Laparoscopic Common Bile Duct Exploration is feasible and secure.