ERCP+LC Vs.LC+LCBDE Management For Cholecystolithiasis And Choledocholithiasis:A Retrospective Clinical Study

Objective:To analyze the therapeutic effect of laparoscopic cholecystectomy and common bile duct exploration(LC+LCBDE)and endoscopic retrograde cholangiopancreatography and laparoscopic chol-ecystectomy(ERCP + LC)intreatment of cholecystolithiasis and choled-ocholithiasis.Methods:111 patients with cholecystolithiasis and choledocholithiasis who were hospitalized in The First Affiliated Hospital of Chongqing Medical University from June 2016 to February 2018.Which were devided into two groups:LC+LCBDE group(Laparoscopic cholecystectomy and common bile duct exploration group)and endoscopic retrograde cholangiopancreatography and ERCP+LC group(laparoscopic cholecy-stectomy group).LC+LCBDE group included 48 cases,and ERCP+LC group included 63cases.We compared two operation plans in operation time,blood loss,conversion to laparotomy rate,stone retaining rate,drainage tube removing time,hospitalization time,food feeding time,postoperative activity time,postoperative complications and hospitalization cost,to analysis the differences between them.Results:There was significant difference between LC+LCBDE group and ERCP+LC group in operation time,blood loss,conversion to laparotomy rate,hospitalization time,drainage tube removing time,food feeding time and postoperative activity time(P<0.05).In those aspects,ERCP+LC group was less than LC+LCBDE group.In postoperative complications,especially in the probability of occurrence of post-ERCP pancreatitis,LC+LCBDE group was lower than ERCP+LC group(P<0.05).ERCP+LC group was significantly higher than LC+LCBDE group in hospitalization cost.And there was no significant difference in stone retaining rate,postoperative complications(excepting the probability of occurrence of post-ERCP pancreatitis)between two groups(P>0.05).Conclusion:(1)ERCP+LC can shorten the hospitalization time,food feeding time and postoperative activity time effectively.And it was better than LC+LCBDE in reducing operation time and blood loss.(2)ERCP+LC has a higher probability of occurrence of post-ERCP pancreatitis,we should be cautious about it.(3)ERCP+LC has a higher cost more than LC+LCBDE,we should choose the appropriate treatment plan according to the patient's actual condition,we suggest an individual-based treatment.