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 (x2 =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 (x2 =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.