The Vale Of Minimally Invasive Treatment Of Reoperation In Extrahepatic Biliary Stones

Objectives To compare the effect of the combined appliances of laparoscopic and choledochoscopic with which of traditional open choledocholithotomy T-tube drainage(OCHTD), to investigate the feasibility and safety of laparoscopic combined with choledochoscopic in the treatment of reoperation of extrahepatic bile duct stones.Methods Retrospective analysis of North China University of Science and Technology Affiliated Kailuan General Hospital between January 2010-December 2014 were treated 239 cases of reoperation in patients with biliary calculi based surgical group is divided into 123 cases of 116 cases of laparoscopic and conventional open surgery group. Comparative analysis of two operative time, blood loss, postoperative gastrointestinal function recovery time, the number of postoperative analgesia, postoperative peritoneal drainage tube removal time, postoperative T-tube occlusion time, postoperative hospital stay and hospital cost.Results 116 cases of laparoscopy group mean operative time 109.7±5.7min, open group 123 patients with a mean operative time was 97.8±7.7min, laparoscopy operative time was higher than the open group time difference was statistically significant(P>0.05), surgery amount of bleeding was 32.7±4.2ml and 40.7±5.9ml, laparoscopy group blood loss was less than the open group difference was statistically significant(P > 0.05), gastrointestinal function recovery time was 1.7±0.1d and 3.0±0.6d laparoscopy group were gastrointestinal function recovery time is shorter than the open group difference was statistically significant(P<0.05),peritoneal tube removal time was 3.5±0.3d and 4.5 ± 0.5d laparoscopy postoperative abdominal drainage tube removal time is shorter than the open group difference was statistically significant(P < 0.05), the number of postoperative analgesia for 1.4±1.0 and2.9±0.7 times laparoscopy postoperative analgesia times fewer than the open group statistical difference significance(P<0.05); postoperative hospital stay was 8.5±0.9d and 12.0 ±1.2d laparoscopy postoperative hospital stay was shorter than the open group difference was statistically significant(P < 0.05); T tube occlusion time was 3.5±0.5d and 4.5±1.0d laparoscopy group T tube clamping time is shorter than the open group difference was statistically significant(P < 0.05); hospitalization costs 20966.5±555.3 Element and22949.6±1354.0 yuan laparoscopy group hospitalization costs Less than open group difference was statistically significant(P<0.05); postoperative complication rate of 3.4% and10.6% in laparoscopy group postoperative complication.Conclusions Compared with the traditional open surgery, laparoscopic combined with choledochoscopic is safe and reliable in the treatment of reoperation of extrahepatic bile duct stones, with minimally invasive and faster recovery characteristics. It is worthy to be popularized and utilized in hospitals. laparoscopic should be used as the preferred surgical and worthy of clinical application.