Investigation of the optimal operative time interval from EST +ENBD to LC / 中国基层医药

ABSTRACT

Objective To investigate the optimal operative time interval from the combined application of endoscopic sphincteropapillotomy ( EST) and endoscopic nasobiliary drainage ( ENBD) to laparoscopic cholecystecto-my ( LC) in the treatment of concurrent cholecystolithiasis and choledocholith.Methods Retrospective analysis was made in the 180 patients who had received sequential treatment of concurrent cholecystolithiasis and choledocholith with the combined application of EFS+ENBD+LC.Patients in group A received LC 3 days after EST +ENBD;patients in group B received LC 7 days after EST +ENBD;patients in group C received LC 30 days after EST +ENBD.Comparative analysis was made in the duration of LC,the intraoperative blood loss,the number of conversion to laparotomy and the total hospital expenses among patients in the three groups.Results Operation time in group A,B and C was separately (34.70 ±2.24)min,(51.00 ±2.31)min and (34.43 ±2.51)min.Patients in group B suffered significantly-extended surgical duration ( F=6.15,P<0.01);Intraoperative blood loss in the three groups was separately (28.86 ±3.35)mL,(50.43 ±3.90)mL,(28.57 ±3.40)mL.Significant increase was observed in group B(F=7.23,P<0.01).There were 1,6 and 1 patients who underwent conversion to laparotomy in the three groups. Slight increase was found in group B(χ2 =6.54,P<0.05).Total hospitalization expenses was separately (10 093.29 ± 496.05)yuan,(10 845.86 ±744.27)yuan and (15 250.57 ±1 006.67)yuan.Patients in group C had incurred a significant increase(F=6.62,P<0.01).Statistical difference was equally found.Conclusion 3 days after EST+ENBD is the optimal operative time for LC.