Clinical Effect of Laparoscopic Cholecystectomy Combined with Simultaneous Endoscopic Cholangiopancreatography for Elderly Patients with Cholecystolithiasis and Secondary Common Bile Duct Stone
Objective To compare the effect of laparoscopic cholecystectomy(LC)combined with simultaneous endoscopic cholangiopancreatography(ERCP),LC combined with laparoscopic choledocholithotomy(LCBDE)for elderly patients with cholecystolithiasis and secondary common bile duct stone(CBDS).Methods A total of 122 elderly patients with cholecystolithiasis and secondary CBDS admitted to the First People's Hospital of Nanyang City from March 2020 to September 2022 were selected and randomly divided into ERCP+LC group and LCBDE+LC group by number table method,with 61 cases in each group.Operative indexes,inflammatory indexes[C-reactive protein(CRP),interleukin-6(IL-6)],liver function indexes[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine amylase(ALT),amylase(AMS)]before and after operation and postoperative complications were compared between two groups.Results The operation time,hospitalization time,the first postoperative exhaust time and the first time of getting out of bed in ERCP+LC group were shorter than those in LCBDE+LC group,and the total intraoperative blood loss was lower than that in LCBDE+LC group(P＜0.05).The stone clearance rate in the ERCP+LC group(98.36％)was higher than that in LCBDE+LC group(86.89％)(P＜0.05).After 1 day of surgery,serum levels of CRP and IL-6 in ERCP+LC group were lower than those in LCBDE+LC group(P＜0.05).After 1 day of surgery,serum levels of TBIL,AMS,AST and ALT in ERCP+LC group were obviously lower than those in the LCBDE+LC group(P＜0.05).There was no statistical difference in the total incidence of postoperative complications between ERCP+LC group and LCBDE+LC group(P＞0.05).Conclusion LC combined with simultaneous ERCP for elderly patients with cholecystolithiasis and secondary CBDS has a higher stone clearance rate,less surgical trauma and less inflammatory reaction,which can effectively protect the liver function of patients and promote rapid postoperative recovery in elderly patients.
endoscopic cholangiopancreatographylaparoscopic cholecystectomygallstonecommon bile duct stoneold age
万方数据
维普
