Abstract:

Objective To explore the complications of laparoscopic cholecystectomy combined with endoscopic sphincterotomy in the treatment of gallbladder and analyze the influencing factors.Methods A retrospective analysis of 136 patients with biliary summary stones admitted to our hospital from April 2015 to April 2016 were divided into groups according to the actual treatment.The control group（n=76）underwent laparoscopic cholecystectomy（LC），the observation group（n=60）underwent LC combined with endoscopic sphincterotomy（EST）.All the patients were followed up for 2 years.The complications were observed，Oddi sphincter pressure and bile were detected，screening and analysis may affect postoperative Factors of complications.Results The incidence of complications in the control group was higher than that in the observation group，but the incidence of complications was not significant（P>0.05）.There was no significant difference in the incidence of liver dysfunction between the two groups（P>0.05）.There was no significant change in CBD pressure and SO base pressure（P>0.05），amplitude of SO contractions（SOCA）and frequency of SO contractions（SOF）.The incidence of the control group was significantly lower than that of the observation group（P<0.05），but the difference of bacterial infection rate between the two groups was not significant（P>0.05）.The course of disease and gallstones，CBD internal diameter，maximum stone diameter and bacterial infection were single factors affecting the complications of LC combined with EST in patients with choledocholith（P<0.05）; disease duration greater than 5 years，with gallstones，CBD internal diameter greater than 15 mm，maximum stones Diameter greater than 15 mm and bacterial infection were independent risk factors for the complications of LC combined with EST in patients with choledocholith（P<0.05）.Conclusion The combined therapy of LC and EST did not increase the risk of postoperative complications in patients with choledocholith，and the disease duration was greater than 5 years，with gallstones，CBD internal diameter greater than 15 mm and maximum stone diameter greater than 15 mm and bacterial infection were independent risk factors for the complications of LC combined with EST in patients with choledocholith.

Key words: choledocholith, laparoscopic cholecystectomy;endoscopic sphincterotomy;complications