Evaluation of Clinical Indications of Three Treatments for Choledocholithiasis with Acute Cholangitis

Figures & data

Table 1 Comparison of General Information

Grouping	ERCP Group (n = 110)	Common Bile Duct Exploration Group (N = 90)	PTCD + Common Bile Duct Exploration Group (n=83)	χ2/F	P value
Gender
Female	68(61.8%)	50(55.6%)	45(54.2%)	1.344	0.511
Male	42(38.2%)	40(44.4%)	38(45.8%)
Age	50.41±15.28	53.41±15.37	52.87±13.96	0.138	0.933
Combined medical diseases	41(37.3%)	36(40.0%)	35(42.2%)	0.484	0.785
Hypertension	21 (19.1%)	17 (18.9%)	17 (20.5%)	0.084	0.959
Coronary heart disease	10 (9.1%)	7 (7.8%)	6 (7.2%)	0.241	0.886
Diabetes mellitus	9 (8.2%)	6 (6.7%)	7 (8.4%)	0.23	0.891
Hyperlipidemia	11 (10%)	9 (10%)	7 (8.4%)	0.127	0.938
Bile duct diameter	10.67±2.97	11.53±2.78	11.54±3.30	2.766	0.065
Number of stones
<2	98 (89.1%)	79 (78.9%)	62 (74.7%)	6.909	0.032
≥ 2	12 (10.9%)	19 (21.1%)	21 (25.3%)
Diameter of stone
<15mm	91 (82.7%)	62 (68.9%)	58 (69.9%)	6.353	0.042
≥15mm	19 (17.3%)	28 (31.1%)	25 (30.1%)
Combined gallstone	108(98.2%)	88(97.8%)	83(100%)	1.674	0.560
Surgical approach
Open surgery	–	34 (37.8%)	33 (39.8%)	0.071	0.789
Endoscopy	–	56 (62.2%)	50 (60.2%)
Whether emergency surgery was performed
Emergency surgery	15 (13.6%)	18 (20.0%)	21 (25.3%)	4.241	0.12
Elective surgery	95 (86.4%)	72 (80.0%)	62 (74.7%)

Note: P < 0.05 indicates statistical significance.

Table 2 Comparison of Live Function in the Three Groups

Grouping	ERCP Group (n = 110)	Common Bile Duct Exploration GROUP (n = 90)	PTCD + Common Bile Duct Exploration Group (N=83)	F	P value
Alanine aminotransferase
Before surgery (U/L)	189.50 (91.75, 261.00)	158.00 (97.00, 252.25)	154.00 (83.00, 324.00)	2.916	0.056
3 days after surgery (U/L)	53.50 (23.75, 126.25)*	62.50 (38.75, 131.25)*	57.00 (38.00, 97.00)*	2.418	0.086
Aspartate aminotransferase
Before surgery (U/L)	113.00 (56.75, 238.25)	92.50 (51.75, 207.75)	77.00 (46.00, 169.00)	2.276	0.505
3 days after surgery (U/L)	41.00 (26.00, 62.25)*	49.00 (30.00, 68.50)*	32.00 (26.00, 58.00)*	2.758	0.066
Gamma-glutamyl transferase
Before surgery (U/L)	340.50 (206.50, 517.0)	340.00 (204.00, 547.2)	309.00 (184.00, 527.0)	5.273	0.006
3 days after surgery (U/L)	151.50 (93.00, 218.50)*	193.50 (137.50, 309.00)*,^#	181.00 (121.00, 287.00)*,^#	6.147	0.003
Total bilirubin
Before surgery (U/L)	45.35(18.93, 91.85)	45.25 (23.15, 100.98)	36.90 (20.00, 91.40)	0.263	0.768
3 days after surgery (U/L)	22.45 (15.25, 36.73)*	25.80 (16.95, 44.10)*	20.90 (13.90, 35.50)*	6.887	0.154

Note: 1. *P < 0.05 compared with preoperative levels; 2. ^#P < 0.05 compared with ERCP group.

Table 3 Comparison of White Blood Cell Count in the Three Groups

Grouping	Before Surgery (×10^9/L)	3 Days After Surgery (×10^9/L)	D-value (×10^9/L)
ERCP group	13.59±5.01	8.64±3.40*	4.95±6.00
Common bile duct exploration group	13.02±5.27	9.23±3.58*	3.79±5.39
PTCD + common bile duct exploration group	12.53±6.48	8.34±2.60*	4.19±6.90

Note: *P < 0.05 compared with preoperative levels.

Table 4 Comparison of the Percentage of Neutrophils in the Three Groups

Grouping	Before Surgery (%)	3 Days After Surgery (%)	D-value (%)
ERCP group	82.83±8.33	73.75±10.46*	9.07±11.75
Common bile duct exploration group	82.16±8.61	73.99±9.35	8.17±11.80
PTCD + common bile duct exploration group	81.83±9.60	72.27±10.31	9.57±12.71

Note: *P < 0.05 compared with preoperative levels.

Table 5 Comparison of Intraoperative Bleeding and Postoperative Hospitalization Days in the Three Groups

Grouping	Cases	Intraoperative Bleeding (mL)	Postoperative Hospitalization Days (d)
ERCP group	110	5(5, 6)	3(2, 4.25)
Common bile duct exploration group	90	25(25, 35)*	11(7, 14)*
PTCD+common bile duct exploration group	83	25(25, 35)*	6(5, 9)*,^#

Notes: 1.*P < 0.05 compared with ERCP group; 2.^#P < 0.05 compared with common bile duct exploration group.

Table 6 Comparison of Postoperative Complications Among the Three Surgical Approaches

Grouping	ERCP group (n = 110)	Common Bile Duct Exploration Group (n = 90)	PTCD + Common Bile Duct Exploration Group (n=83)	χ2	P value
Bile leakage	0(0%)	2(2.2%)	1(1.2%)	2.305	0.285
Backflow of bile duct	3(2.7%)	1(1.1%)	0(0%)	2.098	0.391
Bile duct strictures	2(1.8%)	4(4.4%)	3(3.6%)	1.308	0.578
Postoperative pancreatitis	8(7.3%)	0*(0%)	1(1.2%)	8.754	0.005

Note: *P < 0.016 compared with the ERCP group.

Table 7 Comparison of Incision Healing After Open Surgery in the Common Bile Duct Exploration Group and PTCD + Common Bile Duct Exploration Group

Grouping	Grade A	Grade B	Grade C	χ2	P
Common bile duct exploration group	25(73.5%)	7(20.6%)	2(5.9%)	0.825	0.727
PTCD + common bile duct exploration group	27(81.8%)	5(15.2%)	1(3.0%)

Table 8 Comparison of the Incidence of Postoperative Residual Stones Among the Three Surgical Approaches

Grouping	Residual Stones	No Residual Stones	χ2	P
ERCP group	6(5.5%)	104(94.5)	0.390	0.937
Common bile duct exploration group	4(4.4%)	86(95.6%)
PTCD+common bile duct exploration group	3(3.6%)	80(96.4%)

Table 9 Comparison of the Incidence of Postoperative Stone Recurrence Among the Three Surgical Approaches

Grouping	Stone Recurrence	No Stone Recurrence	χ2	P
ERCP group	1(0.9%)	109(99.1%)	1.010	0.627
Common bile duct exploration group	2(2.2%)	88(97.8%)
PTCD + common bile duct exploration group	2(2.4%)	81(97.6%)