ERCP Combined LC And Open Cholecystectomy Contrast Analysis

Objective : Here we compared the influence of endoscopic retrograde cholangiopancreatography(ERCP)-endoscopic sphincterotomy(EST) combined with laparoscopic cholecystectomy(LC) treatment of cholecystolithiasis and choledocholithiasis on the quality of life of patients using laparotomy cholecystectomy-choledocholithotomy. To determine and explore ways in which surgical treatment of patients is more favorable, which surgical approach is more suitable for use in current clinical work.Methods : A retrospective of 147 cases surgery with cholecystolithiasis and choledocholithiasis beginning January 2012 through December 2014, of which including 96 cases(group A) of LC patients with pre ERCP-EST and 51 cases(group B) with open cholecystectomy-choledocholithotomy, we did the comparison and statistical analysis.Results : The end result of comparing two groups of patients included their general(Male to female ratio of the two groups of patients, median age, preoperative clinical manifestations: abdominal pain, chills, fever cases, jaundice, diabetes,Whether have hypertension risk factors), operative time, blood loss, hospital stay,postoperative pancreatitis, abdominal pain, bile leakage and other common complications and hospitalization costs, the final results contrast in the statistics: A group of 96 patients, male and female ratio of 1: 1.4, aged 23 to 82 years, median age59 years; 51 cases of group B patients, male and female ratio of 1: 1.6, aged 38 to 89 years old, with a median age of 64 year old.A group of patients with mean operative time was 40.73 ± 18.84 minutes, the mean operative time for patients in group B98.38 ± 16.51 minutes. A group of surgical patients average blood loss was 13.15 ±6.67 ml, surgery patients in group B, the average blood loss was 53.37 ± 10.82 ml. A group of patients with postoperative pain(visual score after a day of pain: VAS score)averaged 4.11 ± 1.15, postoperative pain patients in group B averaged 7.49 ± 2.78.The average length of stay of patients in group A was 4.67 ± 1.32 days, the average length of stay of patients in group B was 14.31 ± 2.11 days. A group of patients with an average cost of hospitalization for 30775.50 ± 2659.75 yuan, the average cost of hospitalization for patients in group B 18980.72 ± 3058.16 yuan. A group of patients with postoperative complications(acute pancreatitis, bile duct residual stones, bile duct injury, biliary fistula) incidence averaged 9.37 percent, the incidence of postoperative complications in group B patients averaged 3.92 percent. Above all,There exists a significant difference between group A and group B, which group A shows a specifically decrease trend in terms of operative time, blood loss, biliary complications, postoperative pain(pain visual score: VAS) and length of hospital stay(P< 0.05).Conclusions : In a word, ERCP-EST combined with LC treatment of cholecystolithiasis and choledocholithiasis have advantages like shorter operative time, less blood loss, fewer complications, mild pain and shorter hospital stay.Combination laparoscopic therapy of gallstone biliary stones worth widely implemented in clinical work.