Laparoscopic hepatectomy in treatment of patients with cholangiolithiasis and underlying compensated liver cirrhosis:a comparative study with open approach
Objective This study was to explore the clinical efficacy of laparoscopic hepatectomy(LH)in treating patients with cholangiolithiasis and underlying liver cirrhosis.Methods 59 patients with cholangiolithiasis were recruited in Jingzhou Hospital Affiliated to Yangtze University between June 2018 and June 2023,and all the patients enrolled had underlying compensated liver cirrhosis.20 patients underwent open hepatectomy(OH),and other 20 patients selected by propensity score matching underwent LH.Results The patients in the two groups were matched successfully on body mass index,the etiologies of liver cirrhosis and surgery history,and all operations were successfully completed without switch to OH in LH-treated patients;the surgery time in patients receiving LH was(182.6±97.2)min,much longer than[(170.6±95.7)min,P<0.05],while the intraoperative blood loss and the hepatic inflow occlusion time were(203.5±186.6)ml and(32.3±21.4)min,significantly less or shorter than[(232.2±195.3)ml and(40.6±28.8)min,respectively,P<0.05]in patients receiving OH operation;the post-operationalhospitalstay in patient receiving LH was(8.6±5.7)d,much shorter than[(11.5±3.9)d,P<0.05]in patients underwent OH,while the daily T-tube drainage volumes,postoperative feeding times and mobilization times in the two groups were not significantly different(P>0.05);the incidence of post-operational complications in patients receiving LH was 15.0%,not significantly different compared to 30.0%(P>0.05)in patients receiving OH.Conclusion The laparoscopic hepatectomy in the treatment of patients with cholangiolithiasis and underlying liver cirrhosis is as efficacious as traditional open surgery,with minimally invasive operation virtue,and warrants further clinical verification.