A Preliminary Study On The Clinical Efficacy Of Primary Bile Duct Closure In Laparoscopic Common Bile Duct Exploration

Objective To preliminary search the clinical effect of primary duct closure in laparoscopic common bile duct exploration by retrospective comparative analysis.Methods This retrospective study collected clinical data of patients with choledocholithiasis who met the inclusion and exclusion criteria,and finally treated with LCBDE in the second affiliated hospital of Kunming medical university from January 2013 to January 2019.Which LCBDE+PDC is performed in group A,and LCBDE+TTD is performed in group B.And all the patient data of group A and group B were compared respectively:? The sex ratio and age were compared.?Comparative analysis of the data provided by imaging examination data:The number of bile duct stones,the size of the largest stone and the diameter of the bile duct.?Intraoperative items such as suture time of bile duct and the total operation time were compared.? Compare and analyze the incidence of short-term postoperative complications.?Three general items including postoperative hospitalization time,total postoperative infusion,hospitalization costs,were also compared.? Compare the living conditions and the long-term complications such as bile duct stenosis and stone recurrenceResult 108 patients met the inclusion criteria,including 53 patients in group A and 55 in group B.The results were as follows:?There was no difference in sex ratio and average age between two groups(P>0.05).?No difference were found in quantity of the bile duct stones,size of the two groups(P>0.05).?The average time of bile duct closure of group A is 9.94±1.20 mins,and group B is 16.71±2.07 mins.Average surgery time of group A is 98.52±11.54 mins,while group B is 128.44± 15.89 mins.Both bile duct suture time and the total operation time of group A were less than group B,bile duct suture time,operation time of two groups were statistically different(P<0.05).?The total incidence of short-term postoperative complications was 9.4%in group A and 27.3%in group B,and there was a statistical difference between the two groups(P<0.05).?Mean postoperative hospital stay is 5.08 ± 1.33 days of group A,group B an average of 7.93 ± 2.07 days postoperative hospital stay,and the average postoperative hospital stay of group A is less than group B,The average postoperative infusion volume of group A was 6752± 1498ml,and that of group B was 8431±1237ml.The infusion volume of group A was less than that of group B.The average hospitalization cost of A group is 27.8 ± 7.9k yuan,B group's average hospitalization cost is 32.7± 7.8k yuan,hospitalization cost of group A is less than group B,group A was statistically difference between two groups of the postoperative average hospitalization time,postoperative average infusion volume and hospitalization expenses(P<0.05).?During the follow-up period.the patients were healthy,living without bile duct stenosis recurrence of stones in both groups.Conclusion The results of this study preliminarily indicated that under the same inclusion criteria,compared with laparoscopic common bile duct exploration with T-tube drainage,the choice of primary duct closure may be more advantageous in terms of operation time,hospitalization cost,postoperative hospital stay,and postoperative short-term complications.Moreover,there was no significant difference in the treatment effect and the incidence of long-term postoperative complications.