| Objective To investigate the clinical efficacy and safety difference of laparoscopic common bile duct exploration (LCBDE) and primary suture and laparoscopic transcystic common bile duct exploration (LTCBDE) in the treatment of patients with choledocholithiasis. Methods 150 patients with choledocholithiasis ever treated in our hospital between May 2015 and May 2017 were chosen, and then divided into the control group (75 cases) and the study group (75 cases) by means of random number table. Patients in the control group underwent LCBDE and primary suture of bile duct, and the study group was treated with LTCBDE. Then the operation duration, intraoperative blood loss, postoperative drainage, postoperative intubation time, hospitalization duration, together with blood levels of T lymphocyte subsets and incidence of postoperative complications, were recorded and compared. Results The operation duration, intraoperative blood loss, postoperative drainage, postoperative intubation time and hospitalization duration in the study group were significantly shorter or lower than those in the control group (P<0.05). There was no significant difference in the blood levels of T lymphocyte subsets before and after operation in the study group (P>0.05). The blood levels of CD3+, CD4+ and CD4+/CD8+ after operation in the study group were significantly higher than those in the control group (P<0.05), but the CD8+ level after operation in the study group was significantly lower than that in the control group (P<0.05). The incidence of postoperative complications in the study group was also significantly lower than that in the control group (20.00% vs 4.00%,P<0.05). Conclusion Application of the LTCBDE operation in treatment of those patients with choledocholithiasis could effectively lessen surgical trauma, fasten postoperative recovery, improve cellular immune function, and help to reduce risk of postoperative complications, which might be superior to the operation of LCBDE and primary suture. |
