| Objective:Retrospective data were used to analyze the clinical effect of concurrent endoscopy in the treatment of elderly cholecystolithiasis complicated with mild biliary pancreatitis.Through the collection and comparison of hospitalization and follow-up data,the differences in clinical efficacy of laparoscopic and duodenoscopic staging and concurrent intraoperative combined treatment were understood,so as to provide feasible evidence for the combined treatment of elderly patients with gallstone complicated with mild gallbladder pancreatitis and surgical reference and basis for the clinical treatment of such patients.Methods: According to the experimental design of inclusion criteria and exclusion criteria were collected from January 1,2017 to January 1,2019 the age of 60 or more of gallbladder stone with light gallstone pancreatitis surgical patients,we designed the ERCP and LC surgery time divided into group A and group B,group A for ERCP,first line elective LC again(pre-ERCP + LC),group B for laparoscopic intraoperative joint duodenum mirror one period of treatment,the supine position row first LC,LC is finished to left side A line of ERCP operation(Io-ERCP + LC).Both group A and group B were completed by physicians skilled in laparoscopic and duodenal techniques,and patients were followed up for 1 year after surgery.By collecting the general preoperative data of patients,such as preoperative white blood cells,C-reactive protein,liver function indicators,albumin and other laboratory indicators.Data related to hospitalization for treatment,such as total operative time,total intraoperative bleeding,postoperative complications,length and cost of hospitalization,recurrence rate of stones during follow-up,etc.Statistical software was used to analyze the data.For elderly patients with cholecystolithiasis accompanied by gallstone pancreatitis,whether there was a difference in clinical efficacy between simultaneous dual-lens combined surgery and staged surgery was found.Results: A total of 60 patients were collected,including 30 patients in group A with A male to female ratio of 16:14 and an average age of 70.00±4.68 years.Group B had 30 patients,with a male to female ratio of 15:15 and an average age of 71.03±3.90.Data of patients in the two groups were collected and statistically analyzed.There were no statistical differences in general data between group A and group B,such as age,preoperative pain score,preoperative white blood cell and C-reactive protein,preoperative total bilirubin,GGT,ALT and serum albumin(P>0.05).There was no significant difference in the width of common bile duct(cm)between group A and group B(P>0.05)by comparing the surgical data between the two groups.The mean intraoperative bleeding(ml)of group A was 9.48±3.21,and that of group B was9.40±2.84(P>0.05).The operative time(min)of group A was 131.2±11.22,which was significantly higher than that of group B,97.17±8.40,and the difference was statistically significant(P<0.05).Postoperative complications accounted for 6.66% in group A and3.33% in group B,and there was no statistical difference between the two groups(P>0.05).One case of group A was not removed,and the stone removal rate was 96.7%,while the stone removal rate of group B was 100.0%,and there was no statistical significance between the two groups(P>0.05).The total hospital stay of group A was13.47±1.41 days,which was significantly longer than that of group B,7.27±1.36 days,and there was A significant difference(P<0.05).The hospitalization cost of group A was72407.08±4990.31 yuan,which was significantly different from group B’s56569.39±3508.60 yuan(P<0.05).During the one-year postoperative follow-up,two patients in group A were hospitalized again due to recurrence of calculi and one patient in group B was hospitalized due to recurrence of calculi.There was no statistical difference in the recurrence rate of calculi in 1 year between 2 groups(P > 0.05).Conclusion:For the elderly patients with cholecystolithiasis combined with biliary pancreatitis,at the same time double mirror combination treatment compared to treatment phases short operative time,shorter hospitalization time,hospitalization cost less,elderly patients with higher compliance and does not increase the risk of postoperative complications and recurrence of stones,but more stringent vitreoretinal surgery,need to be careful to control the selection suitable patients,surgical equipment and doctors double entry operation requirements higher,in a hospital with the above conditions can be effectively developed,and the more traditional stage treatment has potential advantages,provides related to patients with a more minimally invasive and effective treatment,the relevant conclusion still needs more support center and high quality research. |
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