Evaluate The Feasibility Of Laparoscopic Trans-cystic Common Bile Duct Exploration

Objective: Cholecystolithiasis are common diseases worldwide.In patients with cholecystolithiasis,10%-20% suffers from both cholecystolithiasis and choledocholithiasis.The patient rapidly develops abdominal pain,chill,high fever,jaundice when common bile duct(CBD)stones obstructive the tract.What was worse,the situation would endanger our heath.In order to reducing adverse reaction,improving prognosis,costing savings,getting the satisfied effects,it is imperative that reasonable treatment regimen should be sought by surgeon.Methods: 80 cases are collected from general surgery department of Shanxi Provincial People's Hospital in July 2016 to August 2017.These cases are all diagnosed with cholecystolithiasis and choledocholithiasis by magnetic resonance cholangiopancreato-graphy(MRCP)and colour duplex ultrasonography.In this study,we separated the cases into two groups,control group(LCCBDE,40cases)and experimental group(LTCBDE,40cases),according to different operation.The index includes the general information of the subjects,such as name,gender,age,hospitalized date,surgically date,leave date,diameter of common bile duct and cystic duct before surgery,the number of stones in common bile duct,maximum diameter of maximum stone,operation time,cost of the surgery,emerging adverse reactions and the patient's contact information.At last,Statistical analysis was performed with SPSS17.0 software package,and effectiveness was analyzed by statistical methods.Results: Among the control group,4 cases are turned LCCBDE into laparotomy because of the impaction of choledocholithiasis.Among the experimental group,3 cases are turned LTCBDE into laparotomy because of the cystic duct is too narrow for choledochoscopy,and,1 cases because of the impaction of choledocholithiasis.Then,the result turns out to be: control group(LCCBDE,37cases)and experimental group(LTCBDE,36cases).There is no statistical difference in gender,age,diameter of common bile duct and cystic duct before surgery,operation time between the two groups(?=0.05,P>?).There is a statistical difference in hospital stay,postoperative length of stay,cost of the surgery,emerging adverse reactions between the two groups(?=0.05,P<?).Conclusion: LTCBDE has a wide scope of application.It can treat cholecystolithiasis and choledocholithiasis at the same time.What`s more,patients received LTCBDE have a shorter hospital stay,much less cost of the surgery and better recovery.Obviously,LTCBDE is much better in the treatment of common bile duct stones than LCCBDE.Nowadays,When we decide to treat our patients,who is suffering from both holecystolithiasis and choledocholithiasis,with laparoscopic choledochotomy for common bile duct exploration(LCBDE),under certain conditions,we should consider using the LTCBDE first.