Efficacy of laparoscopic common bile duct exploration in the treatment of choledocholithiasis with small common bile duct by microincision through the cystic duct confluence
Objective To evaluate the safety and efficacy of laparoscopic common bile duct explora-tion(LCBDE)in the treatment of choledocholithiasis with small common bile duct(CBD)by microincision through the cystic duct confluence.Methods Clinical data of 114 patients with cholecystolithiasis with fine diameter of CBD treated in Hefei Second People's Hospital from February 2014 to April 2021 were retrospec-tively analyzed,including 57 males and 57 females,aged(51.3±15.8)years old.Among them,46 pa-tients underwent primary closure after LCBDE by microincision through the cystic duct confluence(microin-cision group),and 68 patients underwent T-tube drainage after transductal LCBDE(T-tube group).Base-line data,imaging findings,and intraoperative and postoperative clinical data of the two groups were ana-lyzed.Results Baseline data were comparable between the two groups(all P＞0.05).The conversion rate was 2.2％(1/46)in the microincision group and 2.9％(2/68)in the T-tube group(P=1.000).Com-pared to the T-tube group,the microincision group had less intraoperative blood loss[5.0(5.0,10.0)ml vs.10.0(5.0,10.0)ml,P=0.043],shorter operative time[(85.2±32.1)min vs.(102.8±39.5)min,P=0.012],earlier postoperative removal of drainage[(5.1±1.2)d vs.(6.6±1.3)d,P=0.031],and shorter postoperative hospital stay[(6.5±1.7)d vs.(7.4±2.8)d,P=0.025].The utili-zation rate of electro-hydraulic lithotriptic was 4.3％(2/46)in the microincision group and 8.8％(6/68)in the T-tube group(P＞0.05).The incidence of complications was 4.3％(2/46)in the microincision group and 11.8％(8/68)in the T-tube group,with no significant difference between the two groups(P=0.311).There were no cases of biliary stricture and recurrence of stone in either group during follow-up.Conclusion In selected cases,it could be safe and effective to treat choledocholithiasis with fine diameter of CBD by LCBDE through the microincision of the cystic duct confluence.
LaparoscopesCholedocholithiasisCommon bile duct explorationMicroincision through the cystic duct confluence
NETL
NSTL
万方数据
