Abstract:
Objective
To explore the clinical effects of laparoscopic partial hepatectomy (LPH)and laparoscopic common bile duct exploration and stone removal (LCBDE) in the treatment of intrahepatic cholangiolithiasis.
Methods
A total of 88 patients with intrahepatic cholangiolithiasis from April 2014 to March 2020 were retrospectively selected. According to the different surgical methods, they were divided into the LPH group (n=46 cases, undergoing LPH) and the LCBDE group (n=42 cases, undergoing LCBDE).The SPSS27.0 statistical software was used to process the data. Measurement data conforming to the normal distribution were expressed as (![]()
). Independent sample t tests were used for comparisons between groups,and paired sample t tests were used for comparisons within groups. Enumeration data were expressed as［ cases(%)］, and χ2 tests were performed. P<0.05 was considered to indicate a statistically significant difference.
Results
Compared with the LCBDE group, the patients in the LPH group had a longer operation time and more intraoperative blood loss (P<0.05). The levels of alanine aminotransferase (ALT), aspartate aminotransferase(AST), gamma-glutamyl transpeptidase (γ-GGT), and total bilirubin (TBIL) of the patients in both groups were higher than those before the operation at 1 day and 3 days after the operation (P<0.05), and the above indicators in the LPH group were higher (P<0.05). There was no significant difference in the incidence of postoperative complications between the LPH group and the LCBDE group (P>0.05). Compared with the LCBDE group,the patients in the LPH group had a lower residual stone rate after the operation (P<0.05). After a 36-month follow-up after the operation, there was no significant difference in the recurrence rate between the two groups(P>0.05).
Conclusion
Different minimally invasive surgical methods can achieve good effects in the treatment of intrahepatic cholangiolithiasis. LCBDE has more advantages in terms of minimal invasiveness, but it is inferior to LPH in reducing the intraoperative residual stone rate. Therefore, in clinical practice, individualized treatment plans should be selected according to the actual situation of patients.
Key words:
Intrahepatic Cholelithiasis,
Laparoscopes,
Hepatectomy,
Laparoscopic Common Bile Duct Exploration,
Liver Function,
Stone Residual
Teng Zhang, Wei Han, Zhangdong Feng. Clinical study on different minimally invasive surgical approaches for intrahepatic cholangiolithiasis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 384-387.