A comparative study of curative effect between cholecystolithotomy with gallbladder reservation by laparoscopy and choledochoscope and laparoscopic cholecystectomy in patients with cholecystolithiasis

Objective To compare the therapeutic effectiveness between cholecystolithotomy with gallbladder reservation by laparoscopy and choledochoscope and laparoscopic cholecystectomy in the treatment of cholecystolithiasis. Methods The clinical data of 80 cases of cholecystolithiasis in our hospital between January,2014 and January,2016 were analyzed retrospectively.Thirty-seven patients in the gallbladder-preserving surgery (GPS) group received cholecystolithotomy with gallbladder reservation by laparoscopy and choledochoscope,while 43 patients in the laparoscopic cholecystectomy (LC) group underwent laparoscopic cholecystectomy surgery.The difference between the two groups in the total successful rate,incidence of complication,total and postoperative hospitalization time,perioperative bleeding,cases with postoperative drainage,time to first flatus passage,cases with postoperative complication,postoperative pain intensity within 24 hours,recurrence rate of cholecystolithiasis,and gallbladder shrinking functions were compared. Results There were no statistically significance in total successful rate,incidence of complication,total and postoperative hospitalization time and perioperative bleeding between two groups (P>0.05),but the postoperative drainage cases in GPS group was significant more than that in LC group,while the time to first flatus passage,cases with postoperative complication,postoperative pain intensity within 24 hours in GPS group were significant less than those in the LC group (P<0.05).The follow-up showed that there was no recurrent choledocholithiasis in both groups,and the gallbladder shrinking functions at 6 months and 1 year after the operation in GPS group were improved (P<0.05). Conclusion The treatment effectiveness on choledocholithiasis of both GPS and LC is good,safe and feasible.GPS surgery can retain the function of the gallbladder,and improve the patient's quality of life,which is an alternative effective surgical procedure for gallstones.The personalized treatment can be performed on the basis on assessment of gallbladder condition and systemic state and willingness of patients.