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Objective To compare the efficacy of dual-frequency dual-pulse laser lithotripsy under endoscopic retrograde cholangiopancreatography (ERCP) and traditional endoscopic mechanical lithotripsy in the treatment of patients with common bile duct stones, and summarize perioperative nursing measures. Methods From May 2018 to May 2022, the clinical data of 200 patients with common bile duct stones who underwent ERCP treatment and lithotripsy were retrospectively analyzed, of which 69 patients were treated with dual-frequency dual-pulse laser lithotripsy (Laser group) and 131 patients were treated with mechanical lithotripsy (Mechanical group), and the success rate of stone extraction, operation time, postoperative hospital stay time and complications of two groups of patients were compared. Results There was no significant difference in baseline data such as general conditions and preoperative clinical data between two groups (P＞0. 05). Neither neither Laser group nor Mechanical group had reported the perioperative death case. There were no significant difference in postoperative bleeding, postoperative pancreatitis and perforation complication rates in the two groups (P＞0. 05). The surgical time in the Laser group was significantly longer than that in the Mechanical group (P＜0. 05). The postoperative hospital stay was shorter in the Laser group than that in the Mechanical group(P＜0. 05), and the total complication rate and stone residue rate were lower in the Laser group than those in the Mechanical group (P＜0. 05). Conclusion The treatment of common bile duct stones by dual-frequency dual-pulse laser lithotripsy has better efficacy and lower complication rate than traditional surgical mechanical lithotripsy, but there is still room for improvement in the operation time. (目的 比较内镜逆行胰胆管造影术(ERCP)下双频双脉冲激光碎石与内镜下传统机械碎石治疗胆总管结石患者的效果, 总结护理经验。方法 回顾性分析2018年5月—2022年5月在北京中医药大学东方医院消化内镜中心行ERCP治疗并碎石的200例胆总管结石患者的临床资料, 其中69例患者采用双频双脉冲激光碎石术(激光组), 131例患者采用机械碎石(机械组)。比较两组患者的取石成功率、手术时间、术后住院时间、并发症等情况。结果 两组患者一般情况、术前临床资料等基线资料比较, 差异无统计学意义(P＞0. 05)。激光组和机械组均无围术期死亡患者。两组患者术后出血、术后胰腺炎、穿孔并发症率比较差异无统计学意义(P＞0. 05)。与机械组相比, 激光组的手术时间较长(P＜0. 05), 术后住院时间更短(P＜0. 05), 总并发症率和结石残留率更低(P＜0. 05)。结论 ERCP下双频双脉冲激光碎石治疗胆总管结石具有比传统手术机械碎石更好的效果及更低的并发症率, 但手术时间仍有改进的空间。)

Objective To observe the effect of multi-lens combined with T-tube-free surgery in the treatment of cho‐ lecystolithiasis combined with common bile duct stones. Methods Totally 145 cases of surgical treatment of patients with cholecystolithiasis complicated with common bile duct stones were divided into the observation group of 89 cases, and control group of 56 cases. Patients in the observation group underwent T-tube operation scheme according to the common bile duct diameter, while patients in the control group adopted the laparoscopic common bile duct exploration (LCBDE) + T-tube drainage. We observed and recorded the clinical curative effects and postoperative complications in the two groups. Results The operation was successfully completed in both groups. In the observation group, 13 cases underwent laparo‐ scopic cholecystectomy (LC) + synchronous endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic naso‐ biliary drainage (ENBD), 19 cases underwent laparoscopic transcystic common bile duct exploration (LTCBDE), and 57 cases underwent LCBDE+ primary suture + synchronous ERCP+ENBD. Compared with the control group, the observation group had a higher stone removal rate, a lower residual stone rate and a lower reoperation rate (all P<0. 05). Compared with the control group, the operation time of the observation group was longer, the postoperative biliary drainage time was shorter, the abdominal drainage time was shorter, and the postoperative pain NRs score was lower (all P< 0. 05). Com‐ pared with the control group, the Kolcaba psychological score and SF-36 score of quality of life in the observation group were higher (both P<0. 05). Compared with the control group, the incidence of blood amylase which increased > 3 times in the observation group was higher, and the incidences of bile leakage, residual stones, bile duct stenosis and biliary drainage obstruction were lower (all P<0. 05). Conclusion Multi-lens combined with T-tube-free surgery for cholecystolithiasis combined with common bile duct stones is effective, with fewer serious complications, high comfort and good longterm quality of life. [ABSTRACT FROM AUTHOR]

Objective To compare two approaches of single-stage of treating concomitant gallbladder stones and common bile duct stones. Laparoscopic cholecystectomy (LC) was performed with endoscopic retrograde cholangiography (ERCP) as ERCP group and LC combined with laparoscopic common bile duct exploration (LCBDE) as LCBDE group. Intraoperative ERCP was compared with LCBDE. Methods Retrospective analysis was performed for 189 patients with concomitant gallbladder stones and common bile duct stones in our hospital from January 2017 to December 2018. A total of 111 cases were in ERCP group using LC with ERCP and 78 cases in LCBDE group using LC with LCBDE. The efficacy, safety and economy of two approaches were investigated. Results No statistical significance was present between two groups in gender, age, BMI, ASA grade, and preoperative examination (P>0.05). Significant difference was not found in stone clearance rate and postoperative complications(P>0.05). The cases in LCBDE group had wider indication with more patients of gastric surgery history and larger stones. The cases in ERCP group had less hospital days (6.79±2.78 d vs. 13.18±5.43 d, P

Objective: To investigate the clinical efficacy and safety of ERCP/EST-LC on gallbladder stones combined with common bile duct stones. Methods: Taking 80 patients with gallbladder stones and common bile duct stones as the research objects, they were divided into the study group and the control group by random number table method, with 40 cases in each group. The control group underwent LCBDE-LC surgery, and the study group underwent ERCP/EST-LC surgery. The clinical efficacy of patients was investigated by indicators such as surgical success rate, perioperative indicators and postoperative complications. Results: The operation success rate of the control group was 95.0 %, and the operation success rate of the study group was 97.5 %. There was no significant difference between the two groups(P>0.05). There was no significant difference in the operation time and intraoperative blood loss of the study group compared with the control group.(P>0.05), the recovery time of gastrointestinal function in the study group was 39.64 ±5.34 h,which was significantly longer than 37.19±3.17 h in the control group(P<0.05), and the hospital stay in the study group was 14.17±2.06 d, which was significantly longer than the control group 11.85±2.71 d(P<0.05). There was no significant difference in the incidence of biliary tract infection, acute pancreatitis, intestinal perforation, residual stones, and cholangitis between the two groups(P>0.05). The incidence of bile leakage in the control group was 7.50 %, which was significantly higher than the 0.00 % in the study group(P<0.05),and the incidence of postoperative bleeding in the study group was 10.00 %, which was significantly higher than 2.50 % in the control group(P<0.05). The total incidence of complications was 12.50 % in the control group, and 15.00 % in the study group. There was no significant difference between the two groups(P>0.05). The one-year recurrence rate of the control group was 15.00 %, and the recurrence rate of the study group was 17.50 %. According to statistical analysis, there was no significant difference in the recurrence rate between the two groups(P>0.05). The remaining patients had no abdominal pain, fever, jaundice. Conclusion: ERCP/EST-LC treatment of gallbladder stones combined with choledocholithiasis has definite clinical curative effect, few complications and high safety. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety and effectiveness of laparoscopic common bile duct exploration in the treatment of common bile duct stones. Methods A retrospective analysis was conducted for 158 patients with cholecystolithiasis and choledocholithiasis admitted to the Number One Hospital of Zhangjiakou from January 2015 to December 2019.The patients were assigned into three groups according to the diameters of cystic duct and common bile duct,degrees of abdominal infection and tissue edema,and operation method.Group A(16 cases):laparoscopic cholecystectomy,transcystic choledochoscopic exploration for stone removal;Group B(94 cases):laparoscopic cholecystectomy,common bile duct incision exploration combined with choledochoscopy for stone removal,T tube drainage;Group C(48 cases):laparoscopic cholecystectomy,common bile duct incision exploration combined with choledochoscopy for stone removal,primary closure of the common bile duct.The operation time,residual rate of stones,and complication(bleeding,bile leakage,and wound infection) rate were compared between groups. Results The operation time of groups A,B,and C was(95.1±14.7),(102.2±18.1),(110.1±16.4) minutes,respectively,which showed no statistical difference between each other( F =0.020, P =0.887).One case in group A had residual stones,while no residual stone appeared in groups B and C.The overall stone clearance rate was 99.4% and the overall complication rate was 1.9%.There was no perioperative death. Conclusion It is generally safe and effective to carry out laparoscopic cholecystectomy and common bile duct exploration for stone removal in suitable populations.