Clinical effect of laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration in the treatment of gallbladder and extrahepatic bile duct stones complicated with mild acute biliary pancreatitis
LIN Muben WU Peixin ZHU Faqing LIN Guowen ZHONG Shangyin
Department of General Surgery, Lianjiang People′s Hospital, Guangdong Province, Lianjiang 524400, China
Abstract：Objective To investigate the clinical effect of laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC+LCBDE) in the treatment of gallbladder and extrahepatic bile duct stones complicated with mild acute biliary pancreatitis. Methods A total of 88 patients with gallbladder and extrahepatic bile duct stones complicated with mild acute biliary pancreatitis admitted to Lianjiang People′s Hospital from January 2017 to December 2020 were selected as the research subjects. They were divided into the open group (46 cases) and the endoscopic group (42 cases) according to coin tossing method. The open group was treated with open cholecystectomy combined with open common bile duct exploration (OC+OCBDE). The endoscopic group was treated with LC+LCBDE. Compare the surgery related indicators (operation time, intraoperative blood loss, disposable stone clearance rate, postoperative anal exhaust time, feeding time, the length of hospital stay), the serological indexes (aspertate aminotransferase[AST], glutamate pyruvate transaminase [ALT], total bilirubin [TBil], serum amylase [AMS]) level before and after surgery, total incidence of adverse reactions during hospitalization (biliary leakage, cholangitis, wound infection, biliary hemorrhage, pancreatic necrosis) of two groups. Results The intraoperative blood loss in the endoscopic group was less than that in the open group, the first postoperative anal exhaust time, eating time and hospital stay in the endoscopic group were shorter than those in the open group,and the total incidence of adverse reactions in the endoscopic group was lower than that in the open group,the differences were statistically significance (P＜0.05).There were no stastically significances in operation time,single stone clearance rate and AST, ALT, TBil and AMS levels at 7 days after surgery between the two groups (P＞0.05). Conclusion For patients with mild acute biliary pancreatitis complicated with gallbladder and extrahepatic biliary calculi, OC+OCBDE and LC+LCBDE can effectively remove diseased gallbladder, remove extrahepatic biliary calculi, improve liver function and control pancreatic inflammation. However, compared with OC+OCBDE, LC+LCBDE has the advantages of less blood loss, rapid recovery of gastrointestinal function, fewer complications, less pain and rapid recovery, and can promote rapid recovery, which is worthy of clinical promotion of minimally invasive surgery.
林木本；吴培信；朱法清；林国文；钟尚茵. 腹腔镜胆囊切除术联合腹腔镜胆总管探查术治疗胆囊及肝外胆管结石并发轻症急性胆源性胰腺炎的临床效果[J]. 中国当代医药, 2022, 29(5): 9-12.
LIN Muben；WU Peixin；ZHU Faqing；LIN Guowen；ZHONG Shangyin. Clinical effect of laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration in the treatment of gallbladder and extrahepatic bile duct stones complicated with mild acute biliary pancreatitis. 中国当代医药, 2022, 29(5): 9-12.
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