CLINICAL COMPARATIVE STUDY OF ERCP COMBINED WITH GALLBLADDER-PROTECTED LITHOTOMY AND TRADITIONAL LITHOTOMY IN THE TREATMENT OF CHOLEDOCHOLITHIASIS COMPLICATED WITH CHOLECYSTOLITHIASIS

Zhenzhen Yang¹, Junbo Hong¹, Cheng Zhang², Yong Zhu¹, Yong Li³, Youxiang Chen^{1, *}

¹Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China - ²Department of Ultrasound Division, First Affiliated Hospital of Nanchang University, Nanchang, PR China - ³Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang, PR China

Objective: To investigate the clinical comparison of endoscopic retrograde cholangiopancreatography (ERCP) combined with traditional and gallbladder-protected lithotomy in the treatment of choledocholithiasis complicated with cholecystolithiasis. 

Methods: 100 patients with choledocholithiasis complicated with cholecystolithiasis were treated in hepatobiliary surgery in our hospital from October 2018 to October 2019. The patients were then retrospectively analysed and divided into a control group (n=56) and an observation group (n=44) according to different therapeutic regimens. The patients in the control group were treated with traditional open cholecystectomy + choledocholithotomy + T-tube drainage. In contrast, the patients in the observation group were treated with ERCP combined with gallbladder-protected lithotomy. The operation time, residual stone rate, average operative blood loss and postoperative gastrointestinal function recovery time were recorded and compared between the two groups. The incidence of postoperative adverse reactions and the average hospitalisation time of the two groups were compared. The clinical comparison of ERCP combined with both traditional and gallbladder-protected lithotomy for the treatment of choledocholithiasis complicated with cholecystolithiasis was explored.

Results: There was no statistical difference in the conversion laparotomy rate between the two groups (P>0.05). The average operation time and blood loss in the observation group were significantly lower than those in the control group (P<0.05 or 0.01). The total adverse reaction rate of the observation group was 9.09%, which was significantly lower than that of the control group (16.07%), and the difference was statistically significant (P<0.05). The residual rate of stones and the recovery time of gastrointestinal function in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The average hospitalisation time and average hospitalisation cost of the patients in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05).

Conclusion: Compared with traditional lithotomy, ERCP combined with gallbladder-protected lithotomy in the treatment of choledocholithiasis complicated with cholecystolithiasis has the advantages of a shorter operation time, smaller blood loss, lower adverse reaction rate and faster recovery, which can be widely used in clinics.