Clinical Effect Analysis of Endoscopic and Laparoscopic Combined Treatment for Patients with Gallstones and Concomitant Choledocholithiasis

CHEN Jian-feng; WANG Bo; HUANG Jun-wei

Abstract：Objective:To discuss the clinical outcome and relative factors of endoscopic and laparoscopic combined treatment for patients with gallstones and concomitant choledocholithiasis.Method:From April 2010 to April 2013,the clinical data of 127 patients diagnosed as gallstones and concomitant choledocholithiasis by iconography and treated by endoscopic and laparoscopic combined treatment were retrospective analyzed.And the correlation between lithotomy successful,no recurrence and clinical factors were analyzed by single factor related analysis and Logistic regression analysis.Result:The successful people accounted for 78.74%(100/127) and calculi residual accounted for 21.26%(27/127).No relapses accounted for 85.04%(108/127) and relapses accounted for 14.96%(19/127) after endoscopic and laparoscopic combined treatment.The single factor related analysis found that lithotomy successful and without recurrence were related to patient age,number of stones,stones of maximum diameter,diameter of common bile duct,no bile duct expansion,common bile duct expansion, merger cholangitis or pancreatitis.In addition,no relapse was also related to lithotomy successful,no history of jaundice and no postoperative complications. The Logistic regression analysis showed that number of stones,diameter of common bile duct,no bile duct expansion,no common bile duct expansion and no combination of cholangitis were the most important of lithotomy successful and without recurrence.In addition,age,no residual stones and no postoperative complications were the most important of without recurrence.Conclusion:Age<55 years old,number of stones<10,no residual stones,diameter of common bile duct≥1 cm,no bile duct expansion,no common bile duct expansion,no combination of cholangitis and no postoperative complications can be used as the predictors of therapeutic success for patients with gallstones and concomitant choledocholithiasis.