Study In The Treatment Of Choledocholi-Thiasis Between "Three Mirrors" United And Traditional Operation

Objective We use comparative analysis of two different treatment of common bile duct stones through the "Three Mirrors" united minimally invasive treatment and open common bile duct exploration (OCBDE),to investigate the feasibility and clinical value in "Three Mirrors" (laparoscopy, duodenoscopy,choledochoscope) united minimally invasive treatment of choledocholithiasis.Methods We collected 80 cases of common bile duct stones in patients with clinical data which from Nanning City the Second People's Hospital general surgery from February 2005 to December 2008 and divided them into the three mirrors united group and the traditional laparotomy group, one of 40 cases (the three mirrors united group) of choledocholithiasis patients who treated with the "Three Mirrors" united minimally invasive treatment, the others 40 cases (the traditional laparotomy group) of choledocholithiasis patients who are treated with open cholecystectomy common bile duct exploration. We use statistical analysis to analysis the two surgical methods through the stone removal rate,the post-operative complications,postoperative analgesic use,average operative time,intraoperative blood loss,gastrointestinal function recovery time,hospital costs,length of stay in hospital and so on. Results In the three mirrors united group,there are 39 successful cases and the success rate is 97.5 percent,1 case of conversion to laparotomy,the stone removal rate is 90 percent. There is no statistical difference of the stone-free rate between the traditional laparotomy group and the three mirrors united group, the post-operative complications,postoperative analgesic use,intraoperative blood loss is significantly lower than the traditional laparotomy group. The recovery time of gastrointestinal function and hospitalization time in the three mirrors united group is shorter than the traditional laparotomy group, but the mean operative time and the mean hospital costs is higher than the traditional open group.Conclusions There is no statistical difference of the success rate of surgery and the stone-free rate between the traditional laparotomy group and the three mirrors united group,but the three mirrors united group of the post-operative complications,postoperative analgesic use,intraoperative blood loss,the recovery time of gastrointestinal function are all superior to the traditional laparotomy group . Therefore,the " Three Mirrors " united minimally invasive treatment is a feasible minimally invasive treatment methods for the choledocholithiasis patients, it can substitute partly for the open common bile duct stone removal surgery, it is worth to further promote the clinical application.