Clinical effect of laparoscopic surgery in treatment of common bile duct stones after subtotal gastrectomy

Objective To investigate the safety and feasibility of laparoscopic surgery in the treatment of common bile duct stones after subtotal gastrectomy. Methods A retrospective analysis was performed for the clinical data of 46 patients with gallstones and common bile duct stones after subtotal gastrectomy who underwent surgical treatment in Luoyang Central Hospital Affiliated to Zhengzhou University from January 2010 to October 2016. Among these patients, 25 underwent laparoscopic cholecystectomy + common bile duct exploration ( laparoscopic group) , and 21 underwent open cholecystectomy + common bile duct exploration ( open group) . The surgical conditions and postoperative complications were compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results No patients died during the perioperative period and 2 patients ( 8. 0%) in the laparoscopic group were converted to open surgery. There were significant differences between the laparoscopic group and the open group in time to ambulation after surgery ( 1. 2 ± 0. 6 d vs 2. 4 ± 1. 2 d, t = 4. 395, P < 0. 001) , time to passage of gas by anus after surgery ( 1. 8 ± 0. 5 d vs 2. 8 ± 0. 8 d, t = 5. 168, P < 0. 001) , and length of postoperative hospital stay ( 5. 2 ± 1. 1 d vs 7. 5 ± 2. 3 d, t = 4. 439, P < 0. 001) . There were no significant differences between the two groups in time of operation, intraoperative blood loss, hospital costs, T tube placement, and rate of residual stones ( all P > 0. 05) . After surgery, 2 patients ( 8. 0%) in the laparoscopic group and3 ( 14. 3%) in the open group experienced complications, and there was no significant difference between the two groups ( P = 0. 495) .Conclusion Laparoscopic surgery is safe and feasible in the treatment of common bile duct stones after subtotal gastrectomy and has the advantages of minimally invasive surgery.