Effect and Safety of LC Combined with LCBDE in the Treatment of Patients with Gallstone and Common Bile Duct Stones

HAN Jianshu; CHEN Zhao; GE Xingpeng

doi:10.14033/j.cnki.cfmr.2024.29.005

Abstract：Objective:To evaluate the effect and safety of laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of patients with gallstone (GS) and common bile duct stones (CBDS).Method:The clinical data of 102 patients with GS and CBDS who admitted to the First People's Hospital of Guannan County from June 2020 to June 2023 were retrospectively studied,they were divided into the observation group (n=51,receiving LC combined with LCBDE treatment) and the control group[n=51,receiving endoscopic sphincterotomy (EST) combined with LC treatment]according to different surgical methods.The perioperative indexes,pain degree[visual analogue scale (VAS)],analgesic pump utilization rate,stress response index,quality of life,complications and stone recurrence were compared between two groups.Result:The operation time of the observation group was longer than that of the control group,the time of getting out of bed and hospitalization time were shorter than those of the control group,the VAS score at 7 d after operation and utilization rate of analgesia pump were lower than those of the control group,the differences were statistically significant (P<0.05);however,there was no significant difference in intraoperative blood loss between two groups (P>0.05);the levels of C-reactive protein (CRP),white blood cell count (WBC) and neutrophil count (NEUT) in the observation group after operation were lower than those in the control group,and the scores of life satisfaction,health index and emotion were higher than those in the control group,the differences were statistically significant (P<0.05);the total incidence of complications in the observation group was 7.84％,which was lower than 23.53％ in the control group,and the difference was statistically significant (P<0.05);there was no significant difference in the recurrence rate between two groups (P>0.05).Conclusion:Compared with EST combined with LC,LC combined with LCBDE has better perioperative recovery effect and lower complication rate in the treatment of GS and CBDS,it is a safe and effective treatment method,but the long operation time is its deficiency.