Comparing three types of operation for treating cholecystolithiasis with choledocholithiasis

Objective To evaluate the different effeotions among laparoseopic choleeysteotomy (LC)combined with bile duct exploration (LCBDE)and stone removal,LC with endoacopic sphincterotomy (EST),and open-choleeysteetomy (OC)with exploration of common bile duct (ECBD)for treating choleeys-tolithiasis with choledocholithiasis.Methods Among 289 cases of choleeystolithiasis and choledocholithla-sis,132 patients were treated by OC with ECBD,36 cases by LC with LCBDE,121 cases by EST combined with LC.The stone residual rate and leakage of bile rate,operation time,the loss of blood in operation,re-covery time of gastrointestinal function,length of hospital stay of the three groups were compared.Results There was no statistical difference in the stone residual rate and leakage of bile rate among the three groups,but OC with ECBD group had significantly longer operation time,more loss of blood in operation,later re-covery time of gastrointestinal function and longer hospital stay than the other groups.Conclusions There are respective indications,advantages and disadvantages in the three groups.We found that the operation of LC with LCBDE is the better choice for the patients of cholecystolithiasis with choledocholithiasis,single choledocholithiasis;However,the patients with obviously infection of biliary tract or acute pancreatitis is not suitable for this method. Key words: cholecystolithiasis; choledocholithiasis; eholecystectomy; laparoacopie; common bile duct exploration; endoscopic sphincterotomy