Retrospective Clinical Study Of LCBDE+LC With Primary Suture VS One-stage ERCP+LC On Cholecystolithiasis And Choledocholithiasis

Objective.To compare the clinical effects of LC+LCBDE with primary suture and one-stage ERCP+LC in the treatment of gallbladder stones with common bile duct stones.Methods.Clinical data of 184 patients with cholecystolithiasis complicated with choledocholithiasis who treated with LCBDE+LC with primary suture and one-stage ERCP+LC in Zhongda Hospital,Southeast University from Oct.2015 to Oct.2018 were collected.According to the surgical method,the patients were divided into LCBDE+LC group(112 cases)and ERCP+LC group(72 cases).We compared the intraoperative and postoperative information of the two groups,such as operation time,blood loss,stone clearance rate,postoperative blood tests,complications,hospitalization time,hospitalization cost and stone recurrence rate,to analysis the differences between them.Results.The operation time in the LCBDE+LC group was less than in the ERCP+LC group(2.47±1.13 h and 3.22±1.12 h,respectively,P < 0.05)and the stone clearance rate of LCBDE+LC group was higher(100% and 93.1%,respectively,P < 0.05).The total cost of hospitalization in the LCBDE+LC group was less than in the ERCP+LC group(38986.59±13608.55 CNY and 49744.11±19639.78 CNY,respectively,P < 0.05).There was no significant difference in blood loss,complications,hospitalization time and stone recurrence rate between two groups(P>0.05).Conclusion.1.LCBDE+LC with primary suture and one-stage ERCP+LC are both safe and effective for the treatment of gallbladder stones with common bile duct stones.2.LCBDE+LC with primary suture has higher stone clearance rate and shorter operation time,which is worthy of promotion.3.LCBDE+LC with primary suture has a lower cost less than one-stage ERCP+LC,which can lighten the economic burden of patients.4.Surgery operation indications and postoperative complications of the two operation plans are different.The choice of surgical methods should be made reasonably according to the characteristics of the patient’s condition,economic ability,the clinical skill of surgeon and the condition of the hospital equipment,to maximize the benefits for patients.