The clinical efficacy of laparoscopy vs open choledocholithotomy plus T tube drainage in treating cholangiolithiasis / 中华普通外科杂志

ABSTRACT

Objective To compare the clinical efficacy of laparoscopic vs open choledocholithotomy plus T tube drainage for the treatment of extra-and intrahepatic cholangiolithiasis.Methods 300 patients with cholangiolithiasis undergoing surgical treatment in the Department of Hepatobiliary Surgery,Guizhou Provincial People's Hospital,from January 2012 to December 2016 were evaluated.Patients were divided into laparoscopic lithotomy of common bile duct plus T tube drainage group (n =120)and open surgery (n =180).Results The difference was not statistically significant in operation time (237 ±32) min,(t =0.671,P =0.504),operation success rate (100％),primary cure rate (81.7％),(x2 =0.400,P =0.531),residual stone rate (18.3％),(x2 =0.400,P =0.531),hospitalization costs (26 ±4) × 103 RMB,(t =0.981,P =0.329),perioperative complications including bile leakage(0),biliary bleeding (0),abdominal hemorrhage (0),acute cholangitis (0),(x2 =0.669,P =1.000),abdominal infection (0) and incisional infection (0),(x2 =1.342,P =0.518) and late complications including biliary stricture(0) and stone recurrence (11.7％),(x2 =0.022,P =1.000) between the two groups.While intraoperative blood loss (25 ± 14)ml,(t =-7.191,P =0.000),postoperative recovery time of gastrointestinal function (1.8 ± 0.6) d,(t =-5.847,P =0.000),postoperative hospital stay (10.1 ± 0.3) d,(t =-3.145,P =0.000),postoperative incision liquefaction (0),(x2 =26.415,P =0.000) were in favor of laparoscopy group with statistically significant difference.Conclusions For the treatment of extra-and intrahepatic cholangiolithiasis,it was feasible and effective for laparoscopic lithotomy of common bile duct plus T tube drainage.