Clinical efficacy of laparoscopy combined with choledochoscopy for exploration common bile duct in treatment of calculus of common bile duct
- VernacularTitle:腹腔镜联合胆道镜下胆总管探查术治疗胆总管结石的临床疗效
- Author:
Yaoxin YANG
1
;
Feng ZHU
1
;
Zhigui LI
1
;
Yin FANG
1
Author Information
- Publication Type:Journal Article
- Keywords: laparoscopy; choledochoscopy; exploration common bile duct; calculus of common bile duct; stone clearance rate
- From: China Journal of Endoscopy 2025;31(2):76-82
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the clinical efficacy of laparoscopy combined with choledochoscopy for exploration common bile duct in treatment of calculus of common bile duct.Methods A retrospective analysis was conducted on clinical data of 102 patients with calculus of common bile duct from January 2022 to April 2024.They were separated into laparoscopic group(n=52,who underwent laparoscopy combined with choledochoscopy for exploration common bile duct)and open group(n=50,who underwent open surgery)according to the different surgical methods used.Perioperative indicators,serum gastrin hormone levels[gastrin and cholecystokinin],liver function[serum total bilirubin and serum total bile acid],and postoperative complications were compared between the two groups.Results There were no statistically significant differences in surgical time and stone clearance rate between the laparoscopic group and the open group(P>0.05),while intraoperative blood loss in laparoscopic group was less than that in open group,the first exhaust time and postoperative hospital stay in the laparoscopic group were shorter than those in open group,the differences were statistically significnat(P<0.05);On the third day after surgery,the serum gastrin levels in both groups were lower than those on the first day before surgery,and the serum cholecystokinin levels were higher than those on the first day before surgery,the differences were statistically significant(P<0.05);On the third day after surgery,the serum gastrin level in the laparoscopic group was higher than that in open group,and the serum cholecystokinin level was lower than that in open group,the differences were statistically significant(P<0.05);Three days after surgery,the levels of serum total bilirubin and serum total bile acid in both groups were lower than those 1 day before surgery,and both indicators in laparoscopic group were lower than those in open group,the differences were statistically significant(P<0.05);The incidence of complications in laparoscopic group was 7.69%,lower than that in open group was 26.00%,,the difference was statistically significant(P<0.05).Conclusion The stone removal effect of laparoscopy combined with choledochoscopy for exploration common bile duct in patients with calculus of common bile duct is comparable to that of open surgery.However,compared with open surgery,this study's surgical procedure is more conducive to the rapid recovery of liver function,reduce the impact on gastrin hormones and the risk of complications,and accelerate the postoperative recovery process.It is worthy of clinical application.
