Comparative analysis of minimally invasive approaches for gallbladder and common bile duct stones: combined endoscopic techniques vs. ERCP with laparoscopic cholecystectomy.
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引用次数: 0
Abstract
Objectives: The combined technology of laparoscopy, choledochoscope and gastroscope was used in the treatment of gallbladder stones combined with common bile duct stones, which consists of laparoscopic cholecystectomy (LC), laparoscopic common bile duct exploration with primary closure (LCBDE-PC) and combined gastroscopic and choledochoscopic transabdominal nasobiliary drainage (GC-NBD). The clinical effects of the combined technology were evaluated based on hospital stay, hospital costs, postoperative complications, recurrence of stones, and overall patient satisfaction.
Methods: From July 2017 to December 2020, 206 patients with gallbladder stones combined with common bile duct stones were reviewed retrospectively. According to the surgical method, the patients were divided into Triple-Scope group (LC + LCBDE-PC + GC-NBD), (n = 38), ERCP + LC group [endoscopic retrograde cholangiopancreatography (ERCP) followed by LC], (n = 96) and T tube group (LC + LCBDE + T tube drainage), (n = 72). The differences in stone size, hospital stay, hospital cost, postoperative gallstone recurrence rate and postoperative complications were compared among three groups.
Results: No postoperative bile leak occurred in Triple-Scope group, and patients were discharged successfully, and the abdominal drain was removed around 3 days after surgery, and the nasobiliary drainage was removed around 5 days after surgery with a hospital stay of 9.5 ± 2.65 days. The length of hospital stay and hospital cost in the Triple-Scope group were lower than those in the ERCP + LC group (P < 0.01), but not significantly different from those in the T tube group (P > 0.05). The diameter of common bile duct and stone size were significantly larger in the Triple-Scope group and T-tube group than in the ERCP + LC group (P = 0.001; P = 0.004), and the recurrence rate of stones in the Triple-Scope group was not significantly different compared with those in the other two groups (P = 0.43).
Conclusions: For patients with gallbladder stones combined with common bile duct stones, the triple-scope combination is safe and effective with fast recovery, and it is worthy of clinical promotion and application.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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