Comparison Of The Curative Effect Of LC+LCBDE And ERCP+LC On Gallbladder Stones With Common Bile Duct Stones

Background and purpose:Cholecystolithiasis combined with choledocholithiasis is a common biliary system disease.In recent years,with the rapid development of minimally invasive choledochal surgery,endoscopic technique and the concept of enhanced recovery after surgery(ERAS),the diagnosis and treatment of cholecystolithiasis combined with choledocholithiasis has entered a minimally invasive era.At present,the main surgical methods used in clinical application are open cholecystectomy+choledocholithotomy+T-tube drainage,laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)+Primary suture of common bile duct or T-tube drainage,laparoscopic cholecystectomy(LC)+ endoscopic retrograde cholangiopancreatography(ERCP)/ Sphincterotomy(EST),laparoscopic cholecystectomy(LC)+laparoscopic choledochus exploration(LCBDE)+endoscopic nasobiliary drainage(ENBD)+choledochus primary suture,in which LC+LCBDE and ERCP+LC are the most widely used.Different from laparoscopic cholecystectomy(LC)has become the first choice in the treatment of cholecystolithiasis.The purpose of this study is to compared with the two minimally invasive methods of LC +LCBDE and ERCP+ LC in the treatment of cholecystolithiasis combined with choledocholithiasis,this study can provide some references for clinical treatment.Materials and methods:The data of 151 cases of cholecystolithiasis complicated with choledocholithiasis from January 2017 to June 2018 in the second Department of Hepatobiliary and Pancreatic surgery in Bethune first Hospital of Jilin University were retrospectively analyzed.Group A(83 cases)was treated with LC+LCBDE,.Group B 68 patients with ERCP+ LC.The operation time,postoperative hospitalization time,total hospitalization cost,surgical success rate,stone removal rate,conversion to laparotomy rate and complication rate were compared between the two groups.Results:There was no significant difference in age,sex,diameter of common bile duct,size of choledocholithiasis between two groups(P > 0.05).There was no significant difference in the rate of conversion to laparotomy and the incidence of complications(P > 0.05).The total hospitalization cost of patients in group B was less than that in group B(P > 0.05),and the difference was statistically significant(P < 0.05).Conclusion:The two minimally invasive operation methods of LC+LCBDE and ERCP+LC are equally safe and effective in the treatment of cholecystolithiasis combined with choledocholithiasis.Individual treatment should be selected according to the specific conditions of the patient and the medical care,which is the most suitable for the patient.