Abstract:

Objective To compare the efficacy of laparoscopic choledochotomy with one-stage suturing and T-tube drainage in the treatment of patients with common bile duct stones. Method 108 patients with common bile duct stones admitted to Xiangshui County People's Hospital in Yancheng City from June 2021 to May 2024 were selected and randomly divided into two groups of 54 each using a random number table method. Both groups underwent laparoscopic common bile duct stone removal surgery, with the control group receiving T-shaped tube drainage and the experimental group receiving primary suture surgery. Compare the surgical outcomes and postoperative recovery indicators, serum inflammatory factor levels, liver function indicators, quality of life, and incidence of postoperative complications between two groups. Result The experimental group had significantly shorter surgical time, postoperative drainage time, intestinal function recovery time, and hospitalization time compared to the control group (P ＜ 0.001). The intraoperative blood output of the experimental group patients was higher than that of the control group, but the difference was not significant (P ＞ 0.05). Before surgery, there was no significant difference in serum inflammatory cytokine levels, liver function indicators, and quality of life between the two groups of patients (P ＞ 0.05). 48 hours after surgery, all inflammatory factor indicators in the experimental group were significantly lower than those in the control group (P ＜ 0.05); The levels of aspartate transaminase and alanine transaminase in the experimental group were lower than those in the control group, and the level of total bilirubin was higher than that in the control group, with signifi cant diff erences (P ＜ 0.001). And the quality of life scores and total scores of the experimental group were significantly higher than those of the control group one month after surgery (P ＜ 0.001). The total incidence rate of patients in the experimental group was 3.70%, which was lower than that in the control group (16.67%), and the difference was significant (P ＜ 0.05). Conclusion Laparoscopic choledochotomy with one-stage suturing is more effective than T-tube drainage in reducing postoperative inflammatory cytokine levels, improving liver function and quality of life, and reducing postoperative complications.

Key words: Laparoscopy, Cut open the common bile duct to remove stones, First stage suturing, T tube drainage