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Laparoscopy Combined with Choledochoscope for Preservation of Gallbladder Compared with Laparoscopic Cholecystectomy in Treatment of Cholecystolithiasis

Author: YinShiDa
Tutor: ZhiXuTing
School: Shandong University
Course: Surgery
Keywords: Laparoscopic Choledochofiberscope Gallstones Gallbladder lithotomy Case-control study
CLC: R657.4
Type: Master's thesis
Year: 2009
Downloads: 62
Quote: 0
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Abstract


Background: gallstones are common diseases worldwide, the incidence rate of approximately 10% of the normal population. Gallstone treatment has always been a world issue. Many treatment for gallstones, such as gravel, RONGSHI row of stone surgery. Since the end of the century the German doctors Langenbuch proposed 19 the famous a \1987 France Mouret P. doctors successfully completed the first laparoscopic cholecystectomy (laparoscopic cholecystectomy, LC), followed in 1989 after the formation in the world-wide endoscopic surgical boom. China's first case of laparoscopic cholecystectomy was completed in February 1991 under the impact of this trend by Xunzu Wu. LC has fundamentally changed the concept of treatment for gallbladder disease. Cholecystectomy in high-risk surgery has become less invasive, and quicker recovery keyhole (keyhole) surgery. Laparoscopic cholecystectomy gallstone treatment into a new era, and to become the preferred means of treatment of gallstone. Especially for patients with asymptomatic gallstones, as well as heart and cerebrovascular complications of patient vital organs, LC expanded indication for cholecystectomy. However, the controversy over whether cholecystectomy for gallstone patients always exist. One hand, with the rapid development of modern imaging and molecular biology, it gradually became aware of the importance of gallbladder function, complications of cholecystectomy brought forward. On the other hand, with the popularity of laparoscopic, endoscopic proficiency by surgeons for minimally invasive surgery, and mastery of the technical details, the retained gallbladder thorough treatment of gallstone possible. Gallbladder lithotomy once again become the focus of the academic community. Comparative studies, the evaluation of this article by laparoscopic Choledochoscope joint gallbladder lithotripsy treatment of gallstones and laparoscopic cholecystectomy endoscopic gallbladder lithotripsy treatment effect and application prospects. Objective: To compare laparoscopic biliary endoscopic gallbladder lithotomy laparoscopic cholecystectomy in the treatment of gallstone efficacy, to explore the surgical indications and contraindications, comprehensive evaluation and follow-up after short and long term effects of the two mirror joint security gall stone surgery treatment effect and application prospect. Laparoscopic method: February 2007 to December 2008 in the Qilu Hospital of Shandong University, biliary endoscopic gallbladder and 21 cases of 25 cases (Paul gall stone group) and laparoscopic cholecystectomy (LC group) lithotomy surgery The pre-clinical data, operative time, intraoperative and postoperative complications, postoperative hospital stay, recurrence rate, and total hospital costs conducted a case-control study. Results: The gallbladder taken the recurrence rate of the rock group and the LC group, and total hospital costs, both non-significant difference (0% vs 0%, 8164.87 ± 836.62 vs 7925.70 ± 691.9l yuan (P gt; 0.05) two groups of patients surgery and postoperative data are shown in Table 2 below. slightly longer operative time in the LC group (53.86 ± 10.07 vs 29.44 ± 6.60 min), the difference was statistically significant (P lt; 0.05) in the evaluation of postoperative recovery indicators the gallbladder stone postoperative hospital stay and surgery, postoperative complications were less than the LC group (3.62 ± 0.97 vs 4.48 ± 0.96d, 1vs3), the difference was statistically significant (P lt; 0.05). gallbladder stone group in hospital costs and LC groups were not statistically different (P gt; 0.05) Conclusion: The premise of rigorous screening surgical indications, laparoscopic Choledochofiberscope gallbladder stone removal surgery than laparoscopic cholecystectomy reflect the intraoperative less damage, less postoperative near and long-term complications, postoperative recovery quick advantage; no significant difference in operative time and total hospitalization costs, and therefore the safety of surgical treatment of gallstone. comprehensive treatment better than laparoscopic cholecystectomy surgery.

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Gallbladder, bile duct
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