A comparative study of LCBDE and LBEPS in the treatment of choledocholithiasis with ≥1.0 cm common bile duct diameter

doi:10.3877/cma.j.issn.1674-3946.2020.05.027

Abstract

Abstract:

Objective

To study the effect of laparoscopic common bile duct exploration with T tube drainage (LCBDE) and laparoscopic common bile duct exploration with primary suture(LBEPS) for the treatment of choledocholithiasis with ≥1.0 cm common bile duct diameter.

Methods

From January 2015 to January 2019, 100 patients with calculi of common bile duct diameter ≥1.0 cm admitted to our hospital were retrospectively analyzed. According to different operative methods, 52 patients were divided into LCBDE group and 48 patients were divided into LBEPS group. SPSS20.0 statistical software was used for analysis. Intraoperative and postoperative indicators, bile duct pressure, quality of life, and stress response were described by (±s), and compared with independent t test. χ² test was used to compare postoperative complications, success rate of stone extraction, residual stone rate and recurrence rate. P<0.05 was considered statistically significant.

Results

Patients in the LBEPS group had shorter drainage time, activity time, feeding time, recovery time of gastrointestinal function and hospitalization time than those in the LCBDE group (P<0.05). Postoperative quality of life score in LBEPS group was higher than that in LCBDE group, and bile duct pressure was lower than that of LCBDE group (P<0.05). The degree of postoperative stress response in the LBEPS group was lower than that in the LCBDE group (P<0.05). The success rate of stone extraction in the LCBDS group was higher than that in the LCBDE group, and the residual and recurrence rates of stones were lower than those in the LBEPE group, but there was no statistical difference between the two groups (P>0.05). The incidence of postoperative complications in the LBEPS group was 3.9% (2/52), which was lower than that in the LCBDE group (18.8% (9/48) (P<0.05).

Conclusion

LBEPS for the treatment of calculi with the diameter of common bile duct ≥1.0 cm can promote the rapid recovery of patients after surgery, reduce the stress response of patients during surgery, and achieve a high success rate of stone extraction, as well as a low incidence of postoperative complications and high safety.

Key words: Choledocholithiasis, Laparoscopes, LCBDE, LBEPS, Comparative effectiveness research

Yuanshu Lian, Gao Huang, Kaiyi Lu, Mingbo Wen. A comparative study of LCBDE and LBEPS in the treatment of choledocholithiasis with ≥1.0 cm common bile duct diameter[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(05): 530-533.

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Figures/Tables 6

References 15

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组别	例	平均年龄(岁)	性别	结石类型
组别	例	平均年龄(岁)	男/女	单发/多发
LCBDE组	52	40.5±1.5	26/26	31/21
LBEPS组	48	40.8±1.3	21/27	25/23
t/χ²值	?	1.065	0.391	0.575
P值	?	0.290	0.532	0.448
组别	例	总胆红素(mmol/L)	直接胆红素(mmol/L)
LCBDE组	52	50.1±5.2	35.4±2.4
LBEPS组	48	50.2±5.3	35.6±2.5
t/χ²值	?	0.095	0.408
P值	?	0.924	0.684

组别	例	平均年龄(岁)	性别	结石类型
组别	例	平均年龄(岁)	男/女	单发/多发
LCBDE组	52	40.5±1.5	26/26	31/21
LBEPS组	48	40.8±1.3	21/27	25/23
t/χ²值	?	1.065	0.391	0.575
P值	?	0.290	0.532	0.448
组别	例	总胆红素(mmol/L)	直接胆红素(mmol/L)
LCBDE组	52	50.1±5.2	35.4±2.4
LBEPS组	48	50.2±5.3	35.6±2.5
t/χ²值	?	0.095	0.408
P值	?	0.924	0.684

组别	引流时间	下床活动时间	可进食时间	胃肠道功能恢复时间	住院时间
LCBDE组	4.3±0.4	3.5±0.6	1.6±0.1	0.7±0.1	7.7±0.6
LBEPS组	3.5±0.3	2.0±0.1	1.1±0.2	0.6±0.1	6.2±0.1
T	12.520	16.820	15.460	8.475	18.302
P	0.001	0.001	0.001	0.001	0.001

组别	引流时间	下床活动时间	可进食时间	胃肠道功能恢复时间	住院时间
LCBDE组	4.3±0.4	3.5±0.6	1.6±0.1	0.7±0.1	7.7±0.6
LBEPS组	3.5±0.3	2.0±0.1	1.1±0.2	0.6±0.1	6.2±0.1
T	12.520	16.820	15.460	8.475	18.302
P	0.001	0.001	0.001	0.001	0.001

组别	胆管压力(mmHg)		生活质量评分(分)
组别	术前	术后	术前	术后
LCBDE组	12.4±1.6	11.7±0.7	76.6±6.5	105.2±9.6
LBEPS组	12.5±1.6	10.1±0.3	76.6±6.4	118.3±12.5
T	0.248	15.060	0.031	5.817
P	0.804	0.001	0.975	0.001

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