| Objective:To investigate the efficacy of laparoscopic common bile duct exploration(Laparoscopic common bile duct exploration LCBDE)and endoscopic contraband pancreatic duct choledochotomy(Endoscopic retrograde cannulation of the pancreatic ERCP)in the treatment of acu te mild and moderate cholangitis caused by calculi.Methods:A retrospective analysis was made of the medical records of 111 patients with calculous acute mild to moderate cholangitis adm itted to Cangzhou People’s Hospital from January 2017 to December 2018.The patients were divided into two groups according to the surgic al methods: double-mirror group(n=41)and Endoscopy Group(n=70).Laparoscopy combined with choledochoscopic common bile duct explor ation and lithotripsy were performed in the double-mirror group.Endos copic cholangiopancreatography(ERCP)and sphincterotomy(Endoscopi c sphincterotomy EST),duodenal papillary balloon dilatation(Endoscop ic papillary balloon dilation EPBD),basket or balloon lithotripsy were p erformed in the endoscopic group.The operation time,hospitalization t ime,hospitalization expenses,postoperative exhaust time,incidence of complications(LCBDEcomplications including bile leakage,incision inf ection,biliary tract hemorrhage,ERCP complications including transient amylase elevation,pancreatitis,biliary tract hemorrhage,etc.),one-tim e stone clearance rate,6 months after operation were recorded.Stone r ecurrence rate and other indicators,through statistical analysis to comp are the therapeutic effect of the two surgical methods.Results:The operation was successful in both groups.There was no case of conversion to open surgery in the double-mirror group.One case in the endoscopy group was converted to open surgery due to se vere bleeding of the biliary tract.The operation time of the double-mir ror group was(103.20±35.80)min,and the operation time of the endo scopy group was(105.60±29.88)min.There was no significant differen ce in the operation time between the two groups(P>0.05),double-mirr or group and endoscope.The hospitalization time was(12.78±2.73)d a nd(11.36±2.65)d,the difference was statistically significant(P<0.05),a nd the endoscopy group was shorter in hospitalization time.The hospit alization expenses of the double mirror group and the endoscopy group were(2.64±0.45)w and(3.15±0.62)w respectively.There was a stati stically significant(P < 0.05),and the double-mirror group had less ho spitalization costs.The postoperative exhaust time of the two groups w as(2.35±0.85)d and(3.24±0.90)d,respectively.The difference between the two groups was statistically significant(P<0.05).The exhaust time of the double-mirror group was faster.The one-time stone removal rate was 100% in the double-mirror group,94.29% in the endoscopy grou p,0 in the double-mirror group,and 8.5% in the endoscopy group.Th e recurrence rate of stones at 6 months after surgery was 0 in the do uble-mirror group and 1.43% in the endoscopy group.There was no si gnificant difference in the comparison between the two groups(P>0.05).There was no significant difference in the comparison between the two groups(P>0.05),There was no significant difference in the rate of one-time stone removal,the incidence of postoperative complications,a nd the rate of stone recurrence 6 months after operation.Conclusion:LCBDE and ERCP are safe and effective in the treat ment of calculi-induced acute mild to moderate cholangitis.There is n o significant difference in the operation time,the rate of one-time calc ulus removal,the incidence of postoperative complications,and the rec urrence rate of stones at 6 months.Laparoscopic common bile duct li thotripsy has the advantages of reducing hospitalization costs and shortening the postoperative exhaust time.Endoscopic lithotripsy has the ad vantage of shortening the length of hospitalization.Clinically,the appro priate surgical method should be selected according to the actual situat ion of the patient. |
