Clinical effect of laparoscope combined with choledochoscope in one-stage treatment of patients with cholecystolithiasis and choledocholithiasis / 中国基层医药

ABSTRACT

Objective:To explore the effect of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis.Methods:Totally 40 patients with cholecystolithiasis complicated with choledocholithiasis in the Second People's Hospital of Anqing from January 2016 to December 2019 were divided into double mirror combined group (20 cases) and open surgery group (20 cases) according to the operation mode.The patients in the double mirror combined group were treated by laparoscope combined with choledochoscope, and patients in the control group were treated by cholecystectomy and common bile duct exploration.The operation time, amount of bleeding, time to first flatus, postoperative complications and blood indicators were compared between the two groups.Results:The amount of bleeding[(32.50±14.82)mL], the length of hospital stay[(17.30±3.34)d], and the incidence of complication[ 5%(1/20)] in the double mirror combined group were lower than those in the open surgery group[(68.50±30.82)mL, (21.15±5.18)d, 40%(8/20)], the operation time[(162.50±56.39)min] in the double mirror combined group was longer than that in open surgery group[(102.25±21.18)min], there were statistically significant differences ( t=4.707, 2.792, 4.473, χ 2=2.692, all P<0.05). The levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and albumin (ALB) in the two groups after operation were lower than those pre-operation, which in the double mirror combined group were better than those in the open surgery group[double mirror combined group (preoperation and postoperation) ALT(215.35±272.00)U/L, (44.60±44.63)U/L, TBIL(38.80±43.23)μmol/L, (16.68±11.93)μmol/L, ALB(42.65±3.25)g/L, (39.58±3.78)g/L; open surgery group(preoperation and postoperation) ALT(201.78±61.14)U/L, (61.14±48.35)U/L, TBIL(80.89±91.16)μmol/L, (40.24±53.61)μmol/L, ALB(39.37±6.81)g/L, (34.11±4.78)g/L], there were statistically significant differences ( t1=2.86, 2.72, 4.02; t2=3.54, 3.89, 4.34, t3=3.56, 4, 12, 4.01, all P<0.05). There was no statistically significant difference in white blood cell count ( P>0.05). Conclusion:The clinical efficacy of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis is better than open surgery.