To study the clinical effect of minimally invasive surgery and laparotomy in the treatment of cholelithiasis and the influence of postoperative biliary tract pressure and gastrointestinal function. The relationship between biliary tract pressure and gastrointestinal function was analyzed.

From January 2016 to January 2018, 124 cases of cholelithiasis treated in our hospital were retrospectively analyzed. In the open group, 60 patients were treated with open surgery. In the minimally invasive group, 64 patients were treated with laparoscopic choledochoscopy combined with holmium laser lithotripsy. The incidence of postoperative complications, the level of blood inflammatory factors, gastrointestinal function and biliary pressure were measured and compared between the two groups. SPSS18.00 statistical software was used to analyze intraoperative and postoperative indexes. The inflammatory factors, postoperative biliary pressure and gastrointestinal motility were showed as ±s and compared with independent t test, χ² test was used to compare the stone residual rate and postoperative complications, the correlation analysis between biliary tract pressure and gastrointestinal motility was made by Spearman correlation analysis, P<0. 05 was considered the difference was statistically significant.

In the minimally invasive group, the operation time, hospitalization days, hospitalization expenses, residual stone rate and complication rate were better than those in the laparotomy group (P<0.05). The levels of serum IL-6, IL-8, TNF-α, MTL, CCK, VIP and biliary tract pressure in the minimally invasive group were significantly lower than those in the laparotomy group on the 3 d and 5 d after operation (P<0.05). There was a negative correlation between biliary tract pressure and gastrointestinal motility index (MTL, CCK course) (r=0.05, P<0.05, respectively), and there was a positive correlation between biliary tract pressure and the level of serum VIP (r=0.712, P<0.05).

Laparoscopic choledochoscopy combined with holmium laser lithotripsy is effective in the treatment of cholelithiasis. The postoperative inflammation factors, biliary tract pressure, gastrointestinal motility index are better. The biliary tract pressure is correlated with gastrointestinal motility.