Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021
A randomized controlled trial of emergency LCBDE + LC and ERCP + LC in the treatment of choledocholithiasis with acute cholangitis.
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Zou Qi, Ding Yue, Li Chun-Sheng, Yang Xiao-Ping
Аннотация
INTRODUCTION: Emergency biliary drainage is the basic treatment for acute cholangitis caused by choledocholithiasis.
AIM: To compare the effectiveness and safety of emergency laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy (LCBDE + LC) and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) for the treatment of choledocholithiasis combined with grade I or II acute cholangitis.
MATERIAL AND METHODS: A total of 80 patients were enrolled in the study, with 40 cases in each group. A prospective randomized controlled study method was adopted, and the eligible patients were randomly divided into two groups in a ratio of 1 : 1 and treated with emergency LCBDE + LC and ERCP + LC, respectively. The relevant clinical data of the two groups were compared.
RESULTS: The operation duration was longer and blood loss was greater in the LCBDE + LC group than in the ERCP + LC group, but the therapeutic cost was significantly lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). There was no severe complication in either group. The total number of cases with complications, incidence of postoperative acute pancreatitis and incidence of hemorrhage were higher in the ERCP + LC group than in the LCBDE + LC group, while the incidence of bile leakage was lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all).
CONCLUSIONS: Both protocols were safe and feasible in the management of grade I or II acute calculous cholangitis. Compared with the protocol of ERCP + LC, the protocol of LCBDE + LC had the advantages of fewer complications and lower therapeutic costs and is worthy of clinical promotion.
AIM: To compare the effectiveness and safety of emergency laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy (LCBDE + LC) and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) for the treatment of choledocholithiasis combined with grade I or II acute cholangitis.
MATERIAL AND METHODS: A total of 80 patients were enrolled in the study, with 40 cases in each group. A prospective randomized controlled study method was adopted, and the eligible patients were randomly divided into two groups in a ratio of 1 : 1 and treated with emergency LCBDE + LC and ERCP + LC, respectively. The relevant clinical data of the two groups were compared.
RESULTS: The operation duration was longer and blood loss was greater in the LCBDE + LC group than in the ERCP + LC group, but the therapeutic cost was significantly lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). There was no severe complication in either group. The total number of cases with complications, incidence of postoperative acute pancreatitis and incidence of hemorrhage were higher in the ERCP + LC group than in the LCBDE + LC group, while the incidence of bile leakage was lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all).
CONCLUSIONS: Both protocols were safe and feasible in the management of grade I or II acute calculous cholangitis. Compared with the protocol of ERCP + LC, the protocol of LCBDE + LC had the advantages of fewer complications and lower therapeutic costs and is worthy of clinical promotion.