Clinical study of laparoscopy combined with homochronous choledochoscopy in the treatment of cholecystolithiasis and choledocholithiasis

Objective: To explore the therapeutic efficacy and clinical value of laparoscopy combined with choledochoscopy for cholecystolithiasis and choledocholithiasis. Methods: Sixty-eight patients were divided into 2 groups according to their wishes,the observation group underwent laparoscopy combined with choledochoscopy,the control group underwent conventional cholecystectomy and choledocholithotomy. Operation time,blood loss,hospital stay,complication and postoperative follow-up were compared between the two groups. Results: One case in the observation group and 2 cases in control group were converted to open cholecystectomy,there were no significant differences( P = 0. 648); the operative time of two groups was not significantly different( P 0. 05); blood loss and the hospital stay in observation group were better than those of control group( P 0. 05); severe complications such as perforation,bleeding, death did not occur in two groups,acute pancreatitis was mild,which was cured after timely treatment; there were statistically significant differences in acute pancreatitis,pulmonary infection and incision infection between the two groups( P 0. 05). 8 weeks after operation,there was not recurrence nor other complications. After 1 year,1 case of residual calculi was found in the control group,and was removed by choledochoscope. Conclusions: Laparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis and choledocholithiasis can reduce the incidence of postoperative complications and pain,draw on each other's strength,give full play to mini-invasive principle. Surgeons should make individualized diagnosis and treatment plan according to the patient's condition,in order to decrease operative complications and increase surgical curative effect.