Analysis of the Efficacy of Combined Minimally Invasive Biscopic Surgery in the Treatment of Diffuse Hepatobiliary Stone Disease
Objective To explore the efficacy of minimally invasive laparoscopic combined choledochoscopic treatment of diffuse hepatic bile duct stone disease.Methods A total of 100 patients with diffuse hepatic choledocholithiasis in the department of hepatobiliary surgery,the First Hospital of Nanping City,Fujian Province,from January 2020 to January 2023 were selected and grouped by the random number table method;the control group (50 cases) underwent conventional open laparotomy,and the observation group (50 cases) underwent minimally invasive laparoscopy combined with choledochoscopy,and the therapeutic effects of the 2 groups were observed.Results The stone removal rate of the observation group was 86.00％,and the surgical excellence rate was 92.00％,which were higher than 68.00％,70.00％ of the control group,and the differences were statistically significant (P<0.05).The intraoperative bleeding in the observation group (33.34±4.87) mL was lower than the intraoperative bleeding in the control group (90.23±8.45) mL,and the operation time (103.23±19.76) min,postoperative recovery of defecation (1.65±0.54) days,and hospital stay (6.23±1.76) days were shorter than those (147.76±22.48) min,(3.25±1.12) days,(15.49±4.59) days in the control group,and the differences were statistically significant (P<0.05).Before treatment,there was no statistically significant difference in the levels of liver function indexes between the 2 groups (P>0.05);after treatment,the observation group showed a statistically significant difference in the levels of alanine aminotransferase (ALT) (30.23±6.87)U/L,aspartate aminotransferase (AST) (26.76±6.96) U/L,γ-glutamyl transpeptidase (GGT) (33.24±4.02) U/L,and total bilirubin (TBil) (10.84±3.65) μmol/L were lower than those in the control group of (36.68±9.21) U/L,(34.07±7.28) U/L,(45.47±4.35) U/L,(15.65±4.04) μmol/L,and the differences were statistically significant (P<0.05).The complication rate of the observation group was 4.00％,which was lower than 16.00％ of the control group,and the difference was statistically significant (P<0.05).The recurrence rate of stones in the observation group was 20.00％ and that in the control group was 22.00％,and the difference was not statistically significant (P>0.05).Conclusion Laparoscopic combined with choledochoscopy minimally invasive surgery in the clinical treatment of patients with diffuse hepatolithiasis is effective,which can not only improve the stone clearance rate,but also prevent liver function damage and avoid postoperative complications to the greatest extent.It is effective and safe,and is worth popularizing.
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