Clinical Study Of Laparoscopic Combined Fiber Choledochoscope Common Bile Duct Cholelithotomy In 30cases

Objective: To investigate the clinical efficacy of laparoscopic combined fiber choledochoscope common bile duct cholelithotomy.Methods:The clinic efficacy of 30 cases with the choledocho-lithiasis or combined cholecystolithiasis received with the laparoscopic combined fiber choledochoscope common bile duct cholelithotomy and 30 patients treated by the traditional operation of Yijishan Hospital of Wannan Medical College from October 2014 to October 2015 were analyzed.Results: The operation was performed successfully in 30 cases,but a case conversions to laparotomy because of badly abdominal adhesions,and the others were using the melthod of laparoscopic combined fiber choledochoscope,the success rate was 96.7%.The study group:The operative time was 100 to 250 min,mean(161.3±30.5)min;postoperative hospitalization time was 5-12 days,mean(8.2 ± 1.8)days;The ventilation time 18-72 h,mean(27.58±12.24)h;postoperation pain total points 1-4,mean(2.5±0.4)points;postoperative activity time 1-3 days,mean(1.2±0.5)days;the intraoperative blood loss was 20-50 ml,mean(24±5)ml;the cost of hospitalization1.85-2.35 ten thousand RMB,mean(1.99±0.52)ten thousand RMB.The control group : The operative time was 120 to 155 min,mean(119.8 ± 25.6)min;postoperative hospitalization time was 7-16 days,mean(12.2 ± 3.4)days;The ventilation time 24-80 h,mean(33.16±9.22)h;postoperation pain total points 3-8,mean(6.2±0.7)points;postoperative activity time 1-5 days,mean(3.1±0.2)days;the intraoperative blood loss was 18-60 ml,mean(28±9)ml;the cost of hospitalization 1.53-2.12 ten thousand RMB,mean(1.86 ± 0.72)ten thousand RMB.The two groups in the operative time,postoperative hospitalization time,The ventilation time,postoperation pain total points,postoperative activity time and the intraoperative blood loss had significant difference(P<0.05).There were 2 cases appeared bile leakage in study group in 3 days.But with the treatment of continuous drainage of abdominal cavity,all of them were clinically cured in 7 days,a case pulmonary infection,but healed up at last.There were 2 cases residual stones with cholangiography.There were 3 cases appeared bile leakage in study group in 7 days.And a cases residual stones with cholangiography.There was no significant difference in recurrence rate between two groups.The were no long-term complications such as common bile duct stricture by followed-up for 6 to 12 months.Conclusion: The method of laparoscopic combined fiber choledochoscope common bile duct cholelithotomy is safe and reliable,and minimally invasive,and accord with the request of modern medical model.It is very worth for clinical recommendation and application.