Clinical study of LC+ LCBDE and ERCP/S+ LC in treating cholecystolithiasis wtih choledocholithiasis

doi:10.3877/cma.j.issn.1674-6899.2017.04.009

Abstract

Abstract:

Objective

To compare therapeutic effects of laparoscopic cholecystectomy plus laparoscopic common bile duct exploration(LC+ LCBDE) and endoscopic retrograde cholangiopancreatography(ERCP)and sphincterotomy (EST) with stone extraction plus laparoscopic cholecystectomy(ERCP/S+ LC) in treating cholecystolithiasis with choledocholithiasis.

Methods

From Jan. 2010 to Dec.2015, 184 patients with cholecystolithiasis and choledocholithiasis were admitted to our hospital. According to different surgical procedure, they were divided into two groups: LC+ LCBDE group with 59 patients and ERCP/S+ LC group with 125 patients. Several indexes including hospital stay time, hospital charges, rate of complications, efficacy of stone clearance, rate of conversion to open procedures were comparatively analyzed in these two groups.

Results

There was statistically significant difference between the LC+ LCBDE and ERCP/S+ LC groups in total hospital stay time and total hospital charges[(13.12 ± 6.47)d vs (11.40 ± 6.83)d, (27 956.24 ± 9 896.90)yuan vs (35 381.35 ± 8 571.20)yuan, P< 0.05]. But there was no statistically significant difference in postoperative hospital stay time and efficacy of stone clearance, rate of complications, and rate of conversion to open procedures. The total hospital stay time of LC+ LCBDE group was longer than that of ERCP/S+ LC group. And the total hospital charges of LC+ LCBDE group was less than that of ERCP/S+ LC group.

Conclusions

Both LC+ LCBDE and ERCP/S+ LC were safe and effective in treating cholecystolithiasis with choledocholithiasis. There was little advantage for LC+ LCBDE with the routine placement of T tube in common bile duct compared with ERCP/S+ LC. But both procedure need improvement. LC+ LCBDE procedure need decrease its total hospital stay time and ERCP/S+ LC procedure need decrease its total hospital charges.

Key words: Laparoscopic cholecystectomy, Laparoscopic common bile duct exploration and stone extraction, Endoscopic retrograde cholangiopancreatography, Endoscopic Sphincterotomy with stone extraction

Yu Cheng, Yunfan Luo, Yu Deng, Xiaoping Luo, Sheng Zhang, Zhiguo Ai, Xiaohui Rao, Yuntao Huang. Clinical study of LC+ LCBDE and ERCP/S+ LC in treating cholecystolithiasis wtih choledocholithiasis[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2017, 10(04): 222-225.

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References 15

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组别	例数	性别(男性/女性，例)	年龄(岁)	黄疸(例)
组别	例数	性别(男性/女性，例)	年龄(岁)	>34.2 μmol/L	≤34.2μmol/L
LC＋LCBDE组	59	25/34	26～84	40	19
ERCP/S＋LC组	125	55/70	23～87	90	35

组别	例数	性别(男性/女性，例)	年龄(岁)	黄疸(例)
组别	例数	性别(男性/女性，例)	年龄(岁)	>34.2 μmol/L	≤34.2μmol/L
LC＋LCBDE组	59	25/34	26～84	40	19
ERCP/S＋LC组	125	55/70	23～87	90	35

组别	例数	总住院时间(d， ±s)	术后住院时间(d， ±s)	总住院费用(元， ±s)	术后并发症[例(%)]	结石取净[例(%)]	中转开腹[例(%)]
LC＋LCBDE组	59	20.17 ± 9.14	13.12 ± 6.47	27 956.24 ± 9 896.90	6(10.17)	56(94.91)	2(3.39)
ERCP/S＋LC组	125	16.59 ± 7.35	11.40 ± 6.83	35 381.35 ± 8 571.20	13(10.40)	121(96.8)	3(2.40)
P值	?	0.005	0.162	0.000	0.806	0.656	0.656

组别	例数	总住院时间(d， ±s)	术后住院时间(d， ±s)	总住院费用(元， ±s)	术后并发症[例(%)]	结石取净[例(%)]	中转开腹[例(%)]
LC＋LCBDE组	59	20.17 ± 9.14	13.12 ± 6.47	27 956.24 ± 9 896.90	6(10.17)	56(94.91)	2(3.39)
ERCP/S＋LC组	125	16.59 ± 7.35	11.40 ± 6.83	35 381.35 ± 8 571.20	13(10.40)	121(96.8)	3(2.40)
P值	?	0.005	0.162	0.000	0.806	0.656	0.656

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