Efficacy of laparoscopic common bile duct exploration and primary duct closure in the treatment of choledocholithiasis / 国际外科学杂志

ABSTRACT

Objective To investigate the clinical efficacy and safety of laparoscopic common bile duct exploration and primary common bile duct closure in the treatment of extrahepatic bile duct calculi.Methods The clinical data of 215 patients undergoing laparoscopic common bile duct exploration from October 2010 to December 2016 in Wuxi Xishan People' s Hospital were retrospectively analyzed.According to the different surgical methods,patients were divided into two groupslaparoscopic common bile duct exploration and primary common bile duct closure group(primary duct closure group,n =122) and laparoscopic common bile duct exploration group(T-tube drainage group,n =93).Operation time,intraoperative blood loss,recovery time of gastrointestinal tract,liver function in postoperative 1 week and hospitalization expenses,postoperative hospital stay(t test) and postoperative complications (x2 test) were compared.All patients were follow-up by clinic and telephone for 6 months.Measurement data were represented as ((x) ± s),and t test was used between the two groups,while count data using x2 or Fisher test.Results The postoperative hospital stay in primary duct closure group and T-tube drainage group was(8.5 ± 1.9) days and (12.5 ±2.4) days respectively,the difference between the two groups was statistically significant(P ＜ 0.05).The hospitalization costs in primary duct closure group and T-tube drainage group were (1 200 ± 300) yuan and (1 400 ± 500) yuan,the difference was statistically significant (P ＜ 0.05).Postoperative analgesia in primary duct closure group and T-tube drainage group was 11 cases and 32 cases statistically,and the difference was statistically significant (P ＜ 0.01).There were no significant difference in the operation time,intraoperative blood loss,recovery time of gastrointestinal tract,liver function 1 week after operation and postoperative bile leakage between the two groups (all P ＞ 0.05).There was no long-term complications in both groups after 6 follow-up months.Conclusion Under favorable operation technology and strictly grasp the surgical indications,laparoscopic common bile duct exploration and primary common bile duct closure has good clinical application value,and can embody minimally invasive and enhance recovery.