Study On The Occurrence Of Common Bile Duct Stone After LC-postoperative Asymptomatic Cholecystolithiasis

Objective:By observing the incidence of common bile duct stone after prophylactic cholecystectomy for asymptomatic cholecystolithiasis,the treatment of asymptomatic cholecystolithiasis was discussed in order to provide a reference for the treatment of this kind of cholelithiasis.Methods:From October 2011 to December 2012,105 inpatients with LC were recruited from the hospital's medical record room;104 patients with gallbladder stones were diagnosed by B-ultrasound at the physical examination center.Then The two groups of patients had never have clinical symptoms and signs who finally were diagnosed as asymptomatic cholecystolithiasis.By strictly limiting inclusion and exclusion criteria,age,gender,gallbladder wall thickness,stone size and shape,BMI,serum bilirubin,bile acid,urinary gallbladder pigment,ALT and AST data were controlled in order to reduce the differences between the two groups of influencing factors.Eventually,according to the above criteria,83 patients who did not meet the requirements were excluded.Non-randomized patients were divided into laparoscopic cholecystectomy group(surgical group)and regular follow-up group(follow-up group).The occurrence of common bile duct stones in the two groups was observed at one,two,and five years,respectively.The final results were determined by using the?~2 test between two groups.Results:It was found that the incidence of common bile duct stone in the two groups within 1and 2 years was 0%(0/65),4.62%(1/49)in the surgical group,and 2.04%(1/49),2.04%(1/49)in the observation group,respectively.The?2 value between the two groups were 1.038 and 0.547,(P=0.247 and P=0.460,respectively),there was no significant difference(P>0.05).The incidence of common bile duct stone in the surgical group was 16.92%(11/65)at 5 years,which was significantly higher than the observation group 4.08%(2/49),P<0.05.Conclusion:Management of asymptomatic cholecystolithiasis should not be prophylactic cholecystectomy to avoid the formation of common bile duct stone after the absence of gallbladder,causing serious adverse effects;other treatment options,such as regular follow-up observation,or endoscopic cholecystectomy to solve the stone problem.