The effect comparison of treatment of choledocholith by laparoscopic common bile duct exploration with primary suture and T-tube drainage
Objective To explore the effect of laparoscopic common bile duct exploration with primary suture and T-tube drainage in treatment of choledocholith.Methods 40 cases of choledocholith patients receiving laparoscopic common bile duct exploration were selected as study subjects,and they were divided into primary suture group and T-tube drainage group by different treatment methods,with 20 cases in each group.The primary suture group was treated by primary suture,and the T-tube drainage group was treated by T-tube drainage.Comparison was made on operation time,intraoperative blood loss,recovery time of gastrointestinal function,hospitalization time,changes of liver function indicators and inflammatory indicators before and on the 3rd day after surgery,and complications between the two groups.Results There was no statistically significant difference in intraoperative blood loss between the two groups(P＞0.05).The operation time,recovery time of gastrointestinal function and hospitalization time in the primary suture group were(91.06±9.08)min,(1.20±0.24)d and(7.22±1.70)d,which were shorter than(108.84±10.67)min,(2.10±0.48)d and(9.57±1.86)d in the T-tube drainage group.The difference was statistically significant(P＜0.05).Before surgery,there was no statistically significant difference between the two groups in terms of total bilirubin(TBIL),aspartate transaminase(AST),alkaline phosphatase(ALP),alanine aminotrasferase(ALT),γ-glutamyltransferase(GGT),C-reactive protein(CRP)and interleukin-1β(IL-1β)(P＞0.05).On the 3rd day after surgery,TBIL,AST,ALP,ALT,GGT,CRP and IL-1β in both groups were all lower than those before surgery;and patients in the primary suture group had TBIL of(19.26±6.74)μmol/L,AST of(59.82±15.36)U/L,ALP of(139.18±18.13)U/L,ALT of(28.47±8.92)U/L,GGT of(90.12±9.28)U/L,CRP of(41.46±5.02)mg/L,IL-1β of(72.58±5.64)pg/ml,which were lower than(25.31±5.08)μmol/L,(85.47±16.19)U/L,(154.24±7.09)U/L,(36.78±10.12)U/L,(99.36±6.46)U/L,(52.84±5.19)mg/L,(84.46±6.01)pg/ml in T-tube drainage group;the difference was statistically significant(P＜0.05).The complication rate of 5%in the primary suture group was lower than 30%in the T-tube drainage group,and the differences were statistically significant(P＜0.05).Conclusion Laparoscopic common bile duct exploration with primary suture for the treatment of choledocholith has short operation time,rapid recovery,significant improvement in inflammatory and liver function indices,and few complications.
Laparoscopic common bile duct explorationPrimary suture of common bile ductT-tube drainageCholedocholith
万方数据
维普
