腹腔镜下胆囊切除术联合腹腔镜下胆总管探查术治疗胆囊结石合并胆总管结石患者疗效研究*

doi:10.3969/j.issn.1672-5069.2024.01.033

Abstract

Abstract: Objective The aim of this study was to select a relatively good biliary drainage for patients with cholecystolithiasis and choledocholithiasis undergoing surgical operation. Methods 85 patients with gallbladder and common bile duct stones were encountered in our hospital between March 2018 and May 2022, and all received laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBD) combination operation. After removal of the gallbladders and the stones, the nasobiliary drainage was conducted in the observation group (n=42) and the T-tube drainage was completed in the control group (n=43). The gastrointestinal quality of life index (GIQLI) was evaluated by questionnaire. Results The drainage tube removal time and medical cost in the observation group were (5.6 ± 1.8) days and (35.0±5.0)thousand yuan, both significantly shorter or less than [(50.5±6.8)days and (39.0±7.0)thousand yuan, P＜0.05]; at day 7 after operation, serum ALT and AST levels in the observation group were (37.1±14.6)U/L and (36.7±16.8)U/L, both much lower than [(79.7±13.8)U/L and (53.5±14.7)U/L, respectively, P<0.05] in the control; one month after operation, the GIQLI score in the observation group was (98.5±3.3), significantly higher than [(81.4±3.9), P＜0.05] in the control; post-operationally, the incidence of abnormal liver function tests in the observation group was 40.5%, much lower than 65.1%(P＜0.05) in the control, while there were no significant differences as respect to the bile leakage, pancreatitis, residual bile duct stones and bleeding occurrence between the two groups (P>0.05). Conclusion The placement of nasobiliary drainage during the LC and LCBDE operation in the treatment of patients with gallbladder and common bile duct stones might be a technical innovation, which could improve the quality of life after operation.

Key words: Cholecystolithiasis, Choledocholithiasis, Laparoscopic cholecystectomy, Laparoscopic exploration of the common bile duct, Nasobiliary drainage, Gastrointestinal quality of life index, Therapy

Hu Guangming, Zhou Tao, Xiao Jie, et al. Combination of laparoscopic cholecystectomy and laparoscopic common bile duct exploration in treatment of patients with gallbladder and common bile duct stones: Is the nasobiliary drainage superior to T-tube drainage?[J]. Journal of Practical Hepatology, 2024, 27(1): 129-132.

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Combination of laparoscopic cholecystectomy and laparoscopic common bile duct exploration in treatment of patients with gallbladder and common bile duct stones: Is the nasobiliary drainage superior to T-tube drainage?

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