Comparison of the effect of double-mirror combined with gallbladder removal and laparoscopic cholecystectomy for gallbladder stones / 中国基层医药

ABSTRACT

Objective@#To compare the effect of double-mirror combined with gallbladder removal and laparoscopic cholecystectomy for gallstones.@*Methods@#From January 2016 to December 2017, 120 patients with gallstones in the Department of Hepatobiliary Surgery of Dongyang People's Hospital were enrolled.The patients were divided into laparoscopic group (n=60) and double-mirror group (n=60) according to the random number table method.Laparoscopic cholecystectomy was performed in the laparoscopic group, and double-mirror (laparoscopic and choledochoscopy) combined with gallstone removal was performed in the double-mirror group.The surgical results of the two procedures were analyzed.Surgical index, postoperative recovery status, postoperative complications and recurrence rate of one year after surgery were observed.@*Results@#The success rate of surgery in both two groups was 100.0%.The operation time of the double-mirror group [(48.2±5.3)min] was significantly longer than that of the laparoscopic group [(41.2±5.8)min](t=6.901, P<0.001). The first exhaust time [(14.3±2.5)h], the first time of getting out of bed [(21.1±3.7)h], and the recovery time of diet [(2.8±0.6)d] in the double-mirror group were significantly shorter than those in the laparoscopic group [(19.2±3.8)h, (25.1±4.8)h, (3.5±0.7)d] (t=8.344, 5.112, 5.881, all P<0.001). There were no statistically significant differences in the amount of bleeding and postoperative hospital stay between the two groups (all P>0.05). The total incidence rate of postoperative complications in the double-mirror group was 3.3%, which was significantly lower than 15.0% in the laparoscopic group (χ2=4.904, P=0.027). In the double-mirror group, the recurrence rate of calculi was 1.7% in 1 year after surgery, which in the laparoscopic group was 0, there was no statistically significant difference between the two groups (χ2=1.008, P=0.315).@*Conclusion@#Double-mirror combined with gallbladder stone removal and laparoscopic cholecystectomy can achieve good stone removal effect, the short-term efficacy is similar to long-term efficacy, laparoscopic cholecystectomy has shorter operation time.Double-mirror combined with gallstone removal has advantages in postoperative recovery and lower complications.