Randomized controlled study on minimally invasive treatment of gall stones with choledocholithiasis
10.3760/cma.j.issn.1007-631X.2018.08.008
- VernacularTitle:胆囊结石合并胆总管结石微创治疗方案的随机对照研究
- Author:
Yusen ZHANG
1
;
Yuehua GUO
;
Jiangang BI
;
Jinfeng ZHENG
;
Shiyun BAO
Author Information
1. 518020,广东省暨南大学第二临床医学院深圳市人民医院肝胆胰外科
- Keywords:
Cholecystolithiasis;
Choledocholithiasis;
Cholecystectomy,laparoscopic
- From:
Chinese Journal of General Surgery
2018;33(8):649-652
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of one stage laparoscopic choledocholithotomy and cholecystectomy vs.ERCP cholecystolithiasis and cholecystectomy (staged) for cholecystolithiasis complicated with choledocholithiasis.Methods From Jan 2015 to Jun 2017,100 consecutive patients underwent randomized one-stage (TCLCBDE + LC) or two-stage (ERCP + subsequent LC) treatment for common bile duct (CBD) stones.Data evaluated were hospital costs,success rate of one-stage versus two-stage management,postoperative morbidity and GIQLI.Results 47 patients underwent ERCP plus LC two-stage treatment while 46 patients underwent one-stage treatment.Overall success rate of primary intervention for CBD stone clearance was 95.7％ and 97.8％ (P =1.0).Postoperative morbidity was 10.6％ vs.6.5％ (P =0.735),and postoperative hospital stay was (16 ± 5) days vs.(11.9 ± 2.9) days (P ＜ 0.01).One-stage laparoscopic transcystic management was the least costly option compared to two-stage management (19 415 ±2 167)yuan vs.(26 767 ±4 387)yuan (P ＜0.01).GIQLI improved faster in one-stage management group.Conclusion Transcystic one-stage management for gall stones with choledocholithiasis results in shorter hospital stay,lower costs and faster recovery than the two-stage management.
