Liu Ling, Guo Qiqi, Shen Weimin
Department of Hepatopancreatobiliary Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
Evid Based Complement Alternat Med. 2022 Apr 28;2022:5668482. doi: 10.1155/2022/5668482. eCollection 2022.
To assess the clinical effectiveness of laparoscopic fiberoptic choledochoscopy versus conventional open surgery for gallbladder stones complicated with common bile duct stones.
In this retrospective study, 110 patients with gallbladder stones complicated with common bile duct stones treated in our institution between May 2018 and April 2020 were recruited and assigned to receive either open surgery (conventional group) or laparoscopic fiberoptic choledochoscopy (experimental group). Outcome measures included intraoperative indices, postoperative indices, postoperative complications, and changes in postoperative blood indices.
Laparoscopic fiberoptic choledochoscopy was associated with less intraoperative bleeding volume and a shorter surgical incision length versus open surgery ( < 0.05). All eligible patients showed similar operative time ( > 0.05). Laparoscopic fiberoptic choledochoscopy resulted in shorter postoperative exhaust time and mean length of stay and a higher mean hospitalization cost versus open surgery ( < 0.05). There was no significant difference in the number of patients with intensive care units (ICU) monitoring or primary suture of the common bile duct between the two groups ( > 0.05). The eligible patients after laparoscopic fiberoptic choledochoscopy experienced fewer complications versus those after open surgery ( < 0.05). Laparoscopic fiberoptic choledochoscopy had a milder impact on postoperative albumin decrease versus open surgery ( < 0.05). No significant difference was found in the postoperative leukocyte changes and total bilirubin decrease between the two groups ( > 0.05).
Laparoscopic fiberoptic choledochoscopy has better perioperative indices outcomes, lower incidence of postoperative complications, smaller postoperative albumin changes, and superior overall performance versus conventional open surgery for gallbladder stones complicated with common bile duct stones.
评估腹腔镜纤维胆道镜与传统开放手术治疗胆囊结石合并胆总管结石的临床疗效。
在这项回顾性研究中，选取了2018年5月至2020年4月在我院接受治疗的110例胆囊结石合并胆总管结石患者，将其分为接受开放手术的患者（传统组）和接受腹腔镜纤维胆道镜手术的患者（试验组）。观察指标包括术中指标、术后指标、术后并发症以及术后血液指标变化。
与开放手术相比，腹腔镜纤维胆道镜手术术中出血量更少，手术切口长度更短（P<0.05）。所有符合条件的患者手术时间相似（P>0.05）。与开放手术相比，腹腔镜纤维胆道镜手术术后排气时间和平均住院时间更短，平均住院费用更高（P<0.05）。两组间重症监护病房（ICU）监测患者数量或胆总管一期缝合患者数量无显著差异（P>0.05）。与开放手术患者相比，接受腹腔镜纤维胆道镜手术的符合条件患者术后并发症更少（P<0.05）。与开放手术相比，腹腔镜纤维胆道镜手术对术后白蛋白降低的影响较小（P<0.05）。两组间术后白细胞变化和总胆红素降低情况无显著差异（P>0.05）。
对于胆囊结石合并胆总管结石，与传统开放手术相比，腹腔镜纤维胆道镜手术围手术期指标更好，术后并发症发生率更低，术后白蛋白变化更小，总体表现更优。
