Clinical Observation of Minimal Invasive Surgery for Cholecystolithiasis with Choledocholithiasis

Objective:To investigate the clinical value of laparoscopy combined with duodenoscope in treatment of cholecystolithiasis with choledocholithiasis.Methods:A total of 74 cases of cholecystolithiasis with choledocholithiasis were selected,44 cases in EST+LC group were treated with endoscopic sphincterotomy and laparoscopic cholecystectomy,30 cases in OC+OCHTD group with routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy.The operation procedure,postoperative recovery and complication were compared between the two groups.Results:① In EST+LC group,operation time was longer than that in OC+OCHTD group,but incision length and bleeding volume less than OC+OCHTD group(P0.01 or 0.05).② The operation succeed rate was respectively 90.91% and 100% in EST+LC and OC+OCHTD group,stone-free rate 100%(EST+LC) and 93.33%(OC+OCHTD),there was no difference between the two groups(P0.05).③ There was significantly difference between EST+LC and OC+OCHTD group in frequency of pain-killer use,duration of postoperative drainage,recovery of function of gastrointestinal tract,anal exsufflation and average hospital stay(P0.01 or 0.05).④ Both EST+LC and OC+OCHTD group had no severe complications and recurrence of stone.Conclusion:Endoscopic sphincterotomy and laparoscopic cholecystectomy could be widely used in clinic for minimal invasion,.quick recovery,few complications and short hospital stay.