Evaluation of the application of ERCP combined with EST and LC in the elderly patients with gallbladder and choledocholithiasis

Objective To explore the clinical effect of different sequential sequences of ERCP combined with ESTand LC in the elderly patients with gallbladder and choledocholithiasis. Methods A total of 114 elderly patients diagnosed as cholecystolithiasis with choledocholithiasis treated in our hospital were selected and divided into Group A (57 cases) and group B (57 cases) by computer random method. ERCP+ EST operation before LC and ERCP+ EST operation after LC operation were respectively adopted by group A and group B. The data of intraoperative, postoperative conditions and postoperative complications were observed and compared. Stata 13.2 statistical software package was used for data analysis. The measurement data of age, BMI and stone size were compared with independent sample t test, the sex composition ratio, postoperative complication and other counting data were compared with the Chi square. Results The interval of operation in group A was significantly lower than that in group B (P 0.05). The total complication rate of group A was 10.5% (6/57), and the total complication rate in group B was 26.3% (15/57). There was a significant difference between two groups (χ2= 4.728, P= 0.030). The incidence of biliary tract infection and total complications in B group were significantly higher than those in group A (P<0.05). Conclusions ERCP+ EST operation before LC can reduce the operative interval time, reduce the incidence rate of iatrogenic bile duct injury, postoperative biliary tract infection and the total complications, and is worthy of clinical promotion. Key words: Cholelithiasis; Choledocholithiasis; Cholecystectomy, Laparoscopic; Cholangiopancreatography, Endoscopic Retrograde