The Effectiveness of Combined Staged Laparoscopic Surgery in the Treatment of Acute Common Bile Duct and Gallbladder Stones
[Objective]To investigate the effectiveness of combined staged laparoscopic surgery in treating pa-tients with acute common bile duct and gallbladder stones.[Methods]Sixty patients admitted to two hospitals with acute common bile duct and gallbladder stones were randomly divided into an observation group and a control group,with 30 patients in each.The control group underwent simultaneous total laparoscopic surgery[laparoscop-ic common bile duct exploration(LCBDE)+laparoscopic cholecystectomy(LC)],while the observation group underwent combined staged laparoscopic surgery[endoscopic sphincterotomy(EST)+endoscopic retrograde cholangiopancreatography(ERCP)+LC].Surgical related indicators,pre-and post-operative intestinal flora lev-els,post-operative complications and prognosis were compared between the two groups.[Results]The operation time,post-operative time to first flatus,and post-operative hospital stay in the observation group were shorter than those in the control group(P＜0.05).The intraoperative blood loss was also less in the observation group(P＜0.05).Compared to the control group,the levels of E.coli and Enterococcus were lower,while the level of Bifidobacterium was higher in the observation group post-operatively(P＜0.05).The rates of post-operative fever and acute pancreatitis were 3.33％and 6.67％,respectively,in the observation group,which were lower than 26.67％and 23.33％in the control group(P＜0.05).There were no significant differences in the rates of post-op-erative bleeding,wound infection,and peritoneal infection between the groups(P＞0.05).[Conclusion]Com-bined staged laparoscopic surgery not only shortens the surgery time,post-operative time to first flatus,and post-operative hospital stay,reduces intraoperative blood loss,but also improves intestinal flora levels in patients with acute common bile duct and gallbladder stones.Moreover,it offers higher safety and better long-term prognosis.
万方数据
维普
