ABSTRACT
Objective:To investigate the clinical difference between primary suture and T tube drainage in laparoscopic choledocholithotomy.Methods:The clinical data of 124 patients treated by laparoscopic choledocholithotomy in Suzhou Municipal Hospital from December 2018 to February 2020 were retrospectively studied. The patients were divided into the primary suture group (71 cases) and the T tube drainage group (53 cases) according to the different surgical methods, and the differences in the relevant treatment indicators were compared between the two groups.Results:There were no statistically significant differences between the two groups in gender, hypertension, diabetes mellitus, preoperative aspartate aminotransferase, preoperative alanine aminotransferase, preoperative total bilirubin, preoperative common bile duct diameter, postoperative length of stay, total cost of hospitalization, postoperative exhaust time, or postoperative biliary leakage, et al. Compared with the T tube drainage group, the primary suture group had more single choledocholithiasis before operation (33 cases vs. 15 cases), shorter operation time: (100.14 ± 38.90) h vs. (140.45 ± 54.17) h, less intraoperative bleeding: (35.70 ± 30.17) ml vs. (49.53 ± 34.58) ml, and later extraction time of Winslow hole drainage tube after operation: (7.15 ± 2.61) d vs. (5.45 ± 3.35) d, and the differences were statistically significant ( P<0.05). Conclusions:Under the condition of strictly controlling the indications of primary suture and being operated by general surgeons who can skillfully operate laparoscope and choledochoscope, laparoscopic choledocholithotomy for primary suture has better curative effect than T tube drainage, and has higher clinical application value.
ABSTRACT
Objective To research the clinical application value of laparoscopic bile duct exploration and the first stage suture for choledocholithiasis. Methods The clinical data of 86 patients with choledocholithiasis were analyzed retrospectively from January 2015 to January 2017 in Affiliated Suzhou Hospital of Nanjing Medical University. According to the different methods of laparoscopic bile duct exploration, they were divided into one stage suture group (observation group, 46 cases) and T tube drainage group (control group, 40 cases). Results The recovery time of gastrointestinal function, hospitalization time and hospitalization expenses in observation group were significantly better than those in control group: (22.71 ± 10.92) h vs. (35.63 ± 11.12) h, (8.4 ± 2.6) d vs. (13.5 ± 2.3) d and (12.1 ± 3.2) thousand yuan vs. (13.5 ± 4.2) thousand yuan, and there were statistical differences (P＜0.05). Conclusions Compared with T tube drainage, the first stage suture after laparoscopic common bile duct exploration has shorter hospitalization time, lower treatment cost and faster recovery. It is a safe and feasible operation method, and is worthy of popularization and application.