Clinical Effect of Double Endoscopic Combined with Common Bile Duct Exploration and Primary Suture of Common Bile Duct with Biliary Stent Implantation in the Treatment of Cholecystolithiasis Complicated with Choledocholithiasis
Objective To study the clinical efficacy of double endoscopic combined with common bile duct exploration and primary suture of common bile duct with biliary stent implantation in the treatment of cholecystolithiasis complicated with choledocholithiasis. Methods A total of 90 patients with cholecystolithiasis and choledocholithiasis who were treated in our hospital from January 2021 to April 2023 were selected as the research objects. They were divided into control group,study 1 group and study 2 group by random number table method,with 30 patients in each group. Control group was treated with laparotomy,study 1 group was treated with double endoscopy combined with common bile duct exploration and T-tube drainage,and study 2 group was treated with double endoscopic combined with common bile duct exploration and primary suture of common bile duct with biliary stent implantation. The operation indexes (intraoperative blood loss,drainage tube indwelling time,operation time,postoperative anal exhaust time,hospitalization time),liver function indexes[glutamyl transpeptidase (GGT),total bilirubin (TBIL)],inflammatory indexes[C-reactive protein (CRP),white blood cell (WBC)]and incidence of postoperative complications were compared among the three groups. Results The intraoperative blood loss and drainage tube indwelling time in study 2 group and study 1 group were shorter than those in control group ( P<0.05),however,there were no significant difference between the study group 1 and the study group 2 (P>0.05).. The operation time,postoperative anal exhaust time and hospitalization time of study 2 group and study 1 group were shorter than those of control group,and those of study 2 group were shorter than those of study 1 group (P<0.05). GGT and TBIL in the three groups were lower than those before operation,and those in study 2 group and study 1 group were lower than those in control group,and those in study 2 group were lower than those in study 1 group (P<0.05). The levels of CRP and WBC in the three groups were higher than those before operation,and those in study 2 group and study 1 group were lower than those in control group,and those in study 2 group were lower than those in study 1 group (P<0.05). The incidence of complications in study 1 group and study 2 group was lower than that in control group,and that in study 2 group was lower than study 1 group (P<0.05).Conclusion Double endoscopic combined with common bile duct exploration and primary suture of common bile duct with biliary stent implantation are more effective in the treatment of cholecystolithiasis complicated with choledocholithiasis,which can reduce postoperative inflammatory reaction,liver injury,improve hepatobiliary function,reduce the incidence of complications,and is conducive to the rehabilitation of patients. It is worthy of clinical application.
Common bile duct explorationCommon bile duct with biliary stent implantationPrimary sutureCholecystolithiasisCholedocholithiasis
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