Clinical effect of laparoscopic cholecystectomy combined with laparoscopic choledocholithotomy T-tube drainage in treatment of gallbladder and common bile duct stones

Objectives To investigate the clinical effect of laparoscopic cholecystectomy (LC) combined with laparoscopic choledocholithotomy T-tube drainage (LCHTD) in the treatment of gallbladder and common bile duct stones.Methods A retrospective analysis was performed for 117 patients with gallbladder and common bile duct stones who underwent surgical treatment in The Central Hospital of Fengxian District from January 2013 to January 2016, and among these patients, 57 underwent LC + LCHTD (LC + LCHTD group) and 60 underwent open cholecystectomy (OC) combined with open choledocholithotomy T-tube drainage (OCHTD) (OC + OCHTD group) .The time of operation, intraoperative blood loss, length of hospital stay, hospital costs, and incidence of postoperative complications were compared between the two groups, as well as the changes in related biochemical parameters after surgery.A repeated measures analysis of variance was used for comparison of values measured at different time points, the t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.Results There was no significant difference in the time of operation between the LC + LCHTD group and the OC + OCHTD group (P>0.05) .Compared with the OC + OCHTD group, the LC +LCHTD group had significantly lower intraoperative blood loss, postoperative fasting time, and length of postoperative hospital stay (t=11.765, 2.978, and 5.876, all P<0.05) , a significantly lower visual analogue scale pain score at 24 hours and 3 and 7 days after surgery (t=2.403, 3.205, and 2.032, all P<0.05) , and significantly higher total hospital costs (t=5.664, P<0.001) .The LC + LCHTD group had a significantly lower incidence rate of total complications than the OC + OCHTD group (χ2=4.173, P<0.05) , and the OC +OCHTD group had a significantly greater reduction in albumin than the LC + LCHTD group (t=10.766, P<0.05) .Conclusion In the treatment gallbladder and common bile duct stones, the patients treated with LC + LCHTD have less surgical trauma and postoperative complications, a shorter length of hospital stay, and faster postoperative rehabilitation, compared with those treated with OC + OCHTD.