Efficacy comparison of two minimally invasive operations on cholecystolithiasis combined with choledocholithiasis / 国际外科学杂志

ABSTRACT

Objective To compare the clinical efficacy of laparoscopic cholecystectomy(LC) + endoscopic sphincterotomy combined with balloon dilation(ESBD) with laparoscopic cholecystectomy(LC) + common bile duct exploration(LCBDE) on cholecystolithiasis combined with choledocholithiasis.Methods The clinical data of 102 patients with gallbladder stones with common bile duct stones from October 2015 to October 2017 were reviewed from the Second Affiliated Hospital of Chongqing Medical University.Forty eight patients received LC + ESBD and 54 patients subjected to LC ± LCBDE.The operation time,intraoperative blood loss,abdominal drainage time,antibiotic utilization rate,stone residue rate were compared between the two groups.Measurement data with normal distribution were represented as (Mean ± SD),and t test was used to compare between groups.Measurement data with skewed distribution were represented as M(P25,P75),Mann-whitney U test was used to compare between groups.Categorical variables were describedas counts and percentages and were compared using chi-square test.Results The operation time,intraoperative blood loss,postoperative abdominal drainage time,and antibiotic utilization rate in the LC + ESBD group were (108.0 ± 23.4) min,(18.0 ± 7.1) ml,(1.83 ± 1.57) d,and 47.9％(23/48).The LC +LCBDE groupa were (169.6±37.8) min,(86.4±37.0) ml,(4.80±2.02) d,and 87.0％ (47/54),respectively,there were statistically significant differences between the two groups(P ＜0.05).The stone residual rate of the LC + ESBD group was 0,and the LC + LCBDE group was 5.6％ (3/54),respectively.There was no significant difference between the two groups(P ＞ 0.05).Conclusions LC + ESBD and LC + LCBDE both are safe and effective methods to treat cholecystolithiasis combined with choledocholithiasis.However,some data of LC + ESBD group are better than the LC + LCBDE group,such as general anesthesia time,surgical trauma and recovery time.Therefore,compared with LC + LCBDE,LC + ESBD may be the more suitable operation type for patients who have cardiovascular diseases and poor tolerance.