ABSTRACT
Objective To compare the effect of primary suture and T tube drainage of laparoscopic common bile duct exploration(LCBDE) in the treatment of patients with choledocholithiasis.Methods A total of 57 patients with calculus of extrahepatic bile duct were selected and they were randomly divided into observation group(n =25,treated by LCBDE) and control group(n =32,treated by T tube drainage).The operation time,postoperative recovery time of gastrointestinal tract,abdominal drainage time,postoperative hospital stay,hospitalization expenses and postoperative complications were recorded and compared between the two groups.Results All the patients were successfully completed surgery,and no patients had open surgery.The recovery time and postoperative hospital stay of the observation group were (1.7 ± 0.5) d,(5.3 ± 1.6) d,respectively,which were significantly shorter than (2.1 ± 0.3) d,(9.2 ± 1.9) d of the control group (t =11.73,6.27,all P ＜ 0.05),and the cost of hospitalization of the observation group was (6873 ± 2 541)RMB,which was significantly higher than (6 079 ± 2 492)RMB of the control group (t =5.93,P ＜ 0.05).The operation time and drainage time of the observation group were (86.3 ± 19.6) min,(89.7 ± 21.6) h,respectively,which were shorter than (97.1 ± 21.1) min,(98.2 ± 22.7) h of the control group,but the differences were not statistically significant(all P ＞ 0.05).There were 4 cases of postoperative bile leakage and 1 case of common bile duct residual stones in the observation group,and the incidence rate of complications was 20.00％.There were 2 cases of bile leakage,3 cases of common bile duct residual stones and 2 cases of biliary peritonitis in the control group,and the incidence rate of complications was 21.87％.There was no statistically significant difference in the incidence rate of complications between the two groups (x2 =0.15,P ＞0.05).All the patients were followed up for 1 to 2 years,the recurrence rate of stones in the observation group was 12.00％,which was similar to 15.60％ in the control group (x2 =0.36,P ＞ 0.05).Conclusion Primary suture of laparoscopic common bile duct exploration has the advantages such as less trauma,less pain,faster recovery and shorter hospital stay in the treatment of patients with choledocholithiasis,which is worthy of clinical application and popularization.
ABSTRACT
Objective To investigate somatostatin effect of on curative effect of laparoscopic operation in treatment of adhesive intestinal obstruction.Methods 80 patients with adhesive intestinal obstruction from January 2013 to May 2014, were randomly divided into control group and observation group, 40 cases in each group; the control group: treated with laparoscopic operation at the same time, from the patients admitted to the hospital after the foundation treatment; the observation group: somatostatin injection based on the treatment in control group.To observe the therapeutic effect of two groups, gastrointestinal decompression drainage, anal exhaust time, hospitalization time, the rate of conversion to surgical operation, postoperative analgesia, postoperative complications, follow-up treatment within 1 years after the recurrence rate, and application of functional EORTC life quality evaluation of the quality of life of two groups of patients with postoperative score.Results After treatment, the total effective rate of control group was 85%, the total efficiency of observation group was 92.50%, but the difference was not statistically significant (χ2 =2.635).After treatment, patients in observation group,the amount of gastrointestinal decompression, intestinal peristalsis recovery time, anal exhaust time, hospitalization time surgical operation and transfer rate were significantly lower than control group (P<0.01).By measuring the quality of life of EORTC scores between two groups, the observation group was significantly higher than the control group, there was significant difference ( P <0.01 ) .The success rate of the operation of the two groups was 100%, the observation group recurrence after 1 years of follow-up, the number of analgesic were significantly lower than the control group, there were significant differences.Complications in the observation group compared with the control group, the difference was not statistically significant (χ2 =2.813).Conclusion Laparoscopic operation in treatment of adhesive intestinal obstruction, given somatostatin can improve the clinical curative effect, shorten the recovery time of patients, reduce the recurrence rate, improve the survival of treatment.