Clinical effect of laparoscopic common bile duct exploration through micro-incision of cystic duct and its junction in for choledocholithiasis / 国际外科学杂志

ABSTRACT

Objective:To investigate the clinical effect of laparoscopic common bile duct exploration through Micro-incision of cystic duct and its junction in for choledocholithiasis.Methods:The clinical data of 62 patients with cholecystolithiasis complicated with choledocholithiasis treated in the Department of hepatobiliary and pancreatic surgery of Huangshi Central Hospital, Edong Healthcare Group from January 2017 to December 2021 were analyzed retrospectively, and were divided into two groups according to different treatment schemes. Among them, 32 cases underwent laparoscopic cholecystectomy, common bile duct exploration and lithotomy (primary suture group), Laparoscopic choledocholithotomy and exploration + T-tube drainage (T-tube Drainage Group) 30 cases. The general data, operation time, intraoperative bleeding, postoperative exhaust time, first time out of bed, postoperative hospital stay, 24-hour postoperative pain score and the incidence of total complications were compared between the two groups.Results:The operation was successfully performed in both groups, there was no perioperative death.There was no significant difference in general data, operation time, intraoperative bleeding and the incidence of total complications between the two groups ( P> 0.05), the postoperative anal exhaust time, the first time out of bed and the postoperative hospital stay in the primary suture group were (20.3±5.8) h, (15.5±4.3) h and (4.5±1.7) d, respectively, which were significantly shorter than those in the T-tube drainage group (28.3±7.9) h, (22.8±6.7) h and (7.0±2.8) d( P<0.05); The hospitalization cost in the primary suture group was (18 725.9±855.8) yuan, which was significantly lower than that in the T-tube drainage group (23 450.7±975.4) yuan ( P< 0.05). The 24-hour pain score (2.7±0.9) scores in the primary suture group was significantly lower than that in the T-tube drainage group (3.8±1.2) scores ( P< 0.05). Conclusion:Laparoscopic common bile duct exploration through micro-incision of cystic duct and its junction is safe and effective, which can accelerate the rehabilitation of patients and reduce the cost of hospitalization, which is more in line with the concept of ERAS.