JOURNAL OF CLINICAL SURGERY ›› 2019, Vol. 27 ›› Issue (8): 661-663.doi: 10.3969/j.issn.1005-6483.2019.08.010

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The research on clinical application value of selective Ⅰphased LC + ERCP with elderly patients in cholecystolithiasis combined with choledocholithiasis

  

  1. Department of Hepatobiliary Surgery,the PLA 101 hospital,Wuxi Taihu Hospital,Wuxi 214044,China
  • Online:2019-08-20 Published:2019-08-20

Abstract: Objective To explore the application value and prospect of selective Ⅰ phased Laparoscopic Cholecystectomy(LC) combined with Endoscopic Retrograde Cholangiopancreatography(ERCP) of the elderly patients in the patients with cholecystolithiasis combined with choledocholithiasis.Methods 60 cases of elderly patients with cholecystolithiasis combined with choledocholithiasis were collected in the two hospitals.The liver function and MRCP examination were performed before the operation,and patients were selected with normal liver enzyme,no jaundice and no abdominal pain as an observation group(30 cases),Ⅰ phased LC+ERCP,and 30 cases of middle-aged patients and young patients with same diseases were collected as the control group in the same period,the two groups of patients in the operation time,intraoperative bleeding,hospital care time and cost and other aspects of the situation were compared,and the satisfaction of the patients were investigated.Results The operative time of the observation group and the control group was(84.2±9.9)min and(81.2±14.1)min,respectively,and the intraoperative blood loss was(50.5±13.0)ml and(50.2±8.3)ml,respectively.The postoperative time of getting out of bed was(10.7±1.4)h and(10.2±1.5)h,respectively,and the hospitalization cost was(29322±854.8)yuan and(29233±878.9)yuan,respectively,which all showed no statistical significance(P>0.05).The length of stay in the observation group and control group was(7.2±1.1)d and(6.5±0.8)d,respectively,with statistically significant differences(P<0.05).No serious complications such as bleeding,perforation,bile leakage,intestinal leakage and bile duct injury occurred during and after operation in the two groups,there was no statistically significant difference in the incidence of complications(P>0.05).Patients' satisfaction score was(96.23±2.70)in the observation group and(96.33±2.63)in the control group,the difference was not statistically significant(P>0.05).Conclusion In the elderly patients with cholecystolithiasis combined with choledocholithiasis,the appropriate patients were selected.Ⅰ phased LC+ERCP treatment is a safe and reliable operation.Although the number of days in hospital is prolonged,it is still of high clinical value and application prospect.It is worth further promotion.

Key words: laparoscopy, cholangiopancreatography, endoscopy, the elderly, cholelithiasis

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