Clinical value of "three-endoscopy" sequential therapy in the treatment of patients with common bile duct stone complicated with gallbladder stone
10.3969/j.issn.1009-0754.2018.02.013
- VernacularTitle:"三镜"联合序贯治疗胆囊结石合并胆总管结石的临床价值探讨
- Author:
Fan JIANG
1
;
Jianjun LI
;
Guojun WU
;
Qiangzi ZHAO
;
Hongsong XING
;
Gang LU
Author Information
1. 武汉市普仁医院、武汉科技大学附属第四临床学院肝胆外科
- Keywords:
Gallbladder stones;
Common bile duct stone;
Laparoscopy;
Bile duct endoscopy;
Duodenal endoscopy
- From:
Journal of Navy Medicine
2018;39(2):129-132,138
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the therapeutic effects of "three-endoscopy" and"two-endoscopy" respectively combined with traditional open surgery in the treatment of gallbladder stone complicated with common bile duct stone , and to explore the clinical value of "three-endoscopy" in the treatment of common bile duct stone complicated with gallbladder stone .Methods First, the pa-tients with upper abdominal surgical history and those patients with common bile duct diameter smaller than 0.6 cm and or those with stone diameter in common bile duct larger than 2.0 cm were screened and excluded from the study .The included patients with con-firmed gallbladder stone complicated with common bile duct stone were divided in accordance with different treatment methods into 4 groups:the traditional open surgery group (or group A), the Laparoscopy plus Bile duct endoscopy group (or group B), the Laparosco-py plus duodenal endoscopy group (or group C) and the"three-endoscopy" group (or group D), each consisting of 50 patients.Com-parisons were made in the success rate of surgery , residual stone rate , blood loss in the process of surgery , surgical time , drainage tube indwelling time , average air exhaust time after surgery , early ambulation time after surgery , cases of early complications and average hospitalization days between the 4 groups.Results There was no significant difference in the success rate of surgery between the"three-endoscopy" group and other treatment groups (P>0.05).The amount of blood loss in the process of surgery [(109.6 ±53.7) ml], surgical time [(117.3 ±53.2)h] and drainage tube indwelling time [(5.3 ±0.2)d] were significantly less than those of group A [(273.6 ±67.3)ml, (162.3 ±23.7)h, (33.6 ±5.3)d](P<0.05), Drainage tube indwelling time were significantly less than those of group A and group B (P<0.05), however, there were no significant differences, as compared with those of group C (P>0.05).In the "three-endoscopy" treatment group, residual stone rate, air exhaust time after surgery, ambulation time after surgery, cases of complications and average hospitalization days were significantly less than those of group A and group C (P >0.05). Conclusion When compared with traditional open surgery and "two-endoscopy" in the treatment of gallbladder stone combined with common bile duct stone , "three-endoscopy" therapy has the advantages of less trauma , less complications , faster recovery , shorter length of stay in hospital , with this reason , it is worth further clinical promotion .
