Endoscopic sphincterotomy and laparoscopic cholecystectomy in treatment of gallbladder stones and common bile duct stones in the elderly
10.3760/cma.j.issn.1007-8118.2017.08.005
- VernacularTitle:十二指肠乳头切开联合腹腔镜胆囊切除术治疗老年性胆囊并胆总管结石
- Author:
Zhijian LIANG
;
Yongping FANG
;
Kunping LI
;
Xiaozai LUO
;
Wuye CHEN
- Keywords:
Endoscopic sphincterotomy;
Laparoscopic cholecystectomy;
Cholelithiasis;
Choledocholithiasis;
Therapeutic effect
- From:
Chinese Journal of Hepatobiliary Surgery
2017;23(8):521-525
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical results of patients with gallbladder stones and common bile duct stones treated either by laparoscopic cholecystectomy followed by endoscopic sphincterotomy (EST + LC) or laparoscopic cholecystectomy + common bile duct exploration (LC + LCBDE) in the elderly patients.Methods A retrospective study was conducted on 96 patients who had common bile duct and gallbladder stones treated from January 2012 to January 2016.The patients were divided into the control group and the observation group.46 patients were in the observation group who underwent LC three days after EST,while the remaining patients were in the control group who underwent LC and LCBDE.The serum amylase levels before LC,operation time,intraoperation bleeding volume,postoperative time to first flatus,total hospitalization stay and total hospitalization costs and incidences of postoperative complication were compared.Results The total operation time was (95.0 ±7.0) minutes and (125.0 ± 18.0) minutes,respectively,(P＜0.05).The total costs in the two group were (39515.0 ±4 135.0) yuan and (28287.0 ± 2 254.0) yuan (P ＜ 0.05),respectively.Postoperative complications were observed in 5 (6.1％) and 10 (13.2％) patients (P ＜ 0.05),respectively.The preoperative serum amylase levels were (97.6 ± 48.5) IU/L and (131.4 ± 68.7) IU/L,respectively.The blood loss was (35.7 ± 8.5) ml and (31.8 ± 7.3) ml,respectively.The postoperative time to first flatus was (1.7 ± 0.5) days and (1.9 ± 0.4) days,respectively.The total hospitalization stay was (16.3 ±2.8) days and (15.2 ±3.7) days.There were no significantly differences (P ＞ 0.05).Conclusions LC carried out on day 3 after EST to treat elderly patients with cholecystolithiasis and choledocholithiasis was safe and efficacious and the treatment had the advantages of minimal trauma,short operative time,rapid recovery and low complication rates.This should be recommended in clinical practice.
