A comparative study of laparoscopic-assisted choledochoscopic cholelithotripsy and laparoscopic cholecystectomy in the treatment of cholecystolithiasis / 中国基层医药

ABSTRACT

Objective@#To compare the efficacy of laparoscopic choledochoscopic cholelithotripsy and laparoscopic cholecystectomy in the treatment of cholecystolithiasis.@*Methods@#A retrospective study was conducted in 81 cases of cholecystolithiasis who admitted to the People's Hospital of Yuci District from March 2013 to March 2018.The patients were divided into control group (n=38, laparoscopic cholecystectomy) and study group (n=43, laparoscopic choledochoscope choledocholithotomy) according to the different surgical method.The perioperative indicators, liver function indicators, recurrence rate and complications were compared between the two groups.@*Results@#The operation time, hospital stay, recovery time of gastrointestinal function, recovery time of diet after operation and intraoperative bleeding volume in the study group were (43.59±4.59)min, (7.24±1.17)d, (15.51±2.09)d, (2.88±0.42)d, (15.07±1.32)mL, respectively, which were better than those in the control group [(55.23±5.47)min, (9.12±1.32)d, (26.48±3.48)d, (3.53±0.58)d, (24.65±1.48)mL] (t=10.411, 6.796, 17.426, 5.823, 6.864, all P=0.000). The levels of total bilirubin (TBIL), alanine transferase (ALT), aspartate aminotransferase (AST) and total protein (TP) at 1 day after operation in the study group were (24.39±2.21)μmol/L, (29.09±4.68)U/L, (29.02±4.41)U/L, (21.95±2.52)g/L, respectively, which were lower than those in the control group [(28.43±2.31)μmol/L, (34.39±4.28)U/L, (35.31±3.08)U/L, (25.28±2.42)g/L] (t=8.038, 5.293, 7.348, 6.046, all P=0.000). TBIL, ALT, ALT, AST, AST, TP levels at 3 days after surgery in the study group were (20.32±2.24)μmol/L, (24.61±4.26)U/L, (23.68±4.79)U/L, (18.94±2.89)g/L, respectively, which were lower than those in the control group [(24.45±2.02)μmol/L, (29.81±3.32)U/L, (27.94±4.50)U/L, (21.41±2.87)g/L] (t=8.669, 6.609, 4.109, 3.851; all P=0.000). The recurrence rates of the control group and the study group were 5.26% (2/38) and 6.98% (3/43), respectively, there was no statistically significant difference between the two groups (χ2=0.102, P=0.749). The incidence of complications in the study group was 4.65% (2/43), which was lower than 21.05% (8/38) in the control group, the difference was statistically significant (χ2=5.015, P=0.025).@*Conclusion@#Compared with laparoscopic cholecystectomy, laparoscopic assisted choledochoscopic choledocholithotomy has better curative effect, it can reduce the damage to liver function, with low incidence of complications, and it has high clinical value.