Clinical effects of two surgical procedures in treatment of gallstones complicated by common bile duct stones:a comparative analysis

Objective To investigate the clinical effects of laparoscopic common bile duct exploration( LCBDE) combined with laparoscopic cholecystectomy( LC) versus endoscopic retrograde cholangiopancreatography( ERCP) / endoscopic sphincterotomy( EST) combined with LC in the treatment of gallstones complicated by common bile duct stones.Methods A retrospective analysis was performed for the clinical data of56 patients with gallstones complicated by common bile duct stones who underwent minimally invasive surgeries in The Second Affiliated Hospital of Xinjiang Medical University from June 2013 to June 2016.Among these patients,24 were treated by LCBDE + LC and 32 were treated by ERCP / EST + LC.The clinical data including success rate of operation,time of operation,time to passage of gas by anus,length of hospital stay,hospital costs,and postoperative complications were compared between these two groups.The t- test was used for comparison of continuous data between groups.Results Of all patients in the LCBDE + LC group,22( 91.67%) underwent a successful surgery and 2( 8.33%)were converted to laparotomy;2 patients experienced bile leakage after surgery.Of all patients in the ERCP / EST + LC group,30( 93.75%)underwent a successful surgery and 2( 6.25%) were converted to laparotomy;6 patients experienced pancreatitis and 1 experienced bleeding after surgery.There were significant differences in incidence of pancreatitis between groups.Compared with the ERCP / EST + LC group,the LCBDE + LC group had significantly shorter time of operation and length of hospital stay and significantly lower hospital costs( t =- 5.818,- 5.393,and- 3.566,all P < 0.05).Conclusion Both LCBDE + LC and ERCP / EST + LC are effective minimally invasive therapies for gallstones complicated by common bile duct stones,but the treatment method should be selected based on patients' condition.