Comparative outcomes of laparoscopic transcystic duct vs traditional laparoscopic bile duct exploration: A multicentre randomised trial

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice Pub Date : 2025-02-05 DOI:10.1111/1744-1633.12742

Ailian Liu MBBS, Ziyang Pan MBBS, Yuwen Liu MMed, Jianhua Wang MMed, Chengbo Wu MMed

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引用次数: 0

Abstract

Aim

This multicentre randomised controlled trial aimed to compare post-operative complications and recovery outcomes between these two approaches.

Patients and methods

Eighty patients with symptomatic choledocholithiasis were randomly assigned to undergo either laparoscopic transcystic (LTCBDE; n = 40) or traditional (LCBDE; n = 40) common bile duct exploration. The primary outcome measures were post-operative complications within 3 months, while the secondary outcomes included operative time, intraoperative blood loss, recurrence of bile duct stones, and time to return to activities of daily living (ADLs). Logistic regression models were used to identify predictors of complications and recurrence.

Results

The LTCBDE group had significantly shorter operative times (117.55 vs 136.05 min, P < .001) and reduced intraoperative blood loss (51.25 vs 61.45 mL, P < .001). Both groups had a 20% rate of post-operative complications (P = .614). Septic complications were higher in LCBDE compared with LTCBDE (20% vs 7.5%, P = .105). Time to return to ADL was shorter in the LTCBDE group (33.4 vs 39.75 days, P = .007). Diabetes mellitus independently predicted post-operative complications (adjusted odds ratio 4.397, P = .014) and revision surgery (adjusted odds ratio 22.592, P = .006). Recurrence rates were similar between groups (P = .363).

Conclusion

LTCBDE is associated with shorter operative times, reduced blood loss, and faster recovery than LCBDE, without an increase in post-operative complications. LTCBDE may be the preferred option for the treatment of choledocholithiasis.

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腹腔镜经胆囊管与传统腹腔镜胆管探查的比较结果：一项多中心随机试验

目的：本多中心随机对照试验旨在比较两种入路的术后并发症和恢复结果。患者与方法80例有症状的胆总管结石患者随机分为两组，一组接受腹腔镜经囊治疗(LTCBDE；n = 40)或传统(LCBDE；N = 40)胆总管探查。主要观察指标为术后3个月内的并发症，次要观察指标为手术时间、术中出血量、胆管结石复发、恢复日常生活活动时间（adl）。Logistic回归模型用于确定并发症和复发的预测因素。结果LTCBDE组手术时间明显缩短（117.55 min vs 136.05 min, P < 001），术中出血量明显减少（51.25 mL vs 61.45 mL, P < 001）。两组术后并发症发生率均为20% （P = .614）。LCBDE组脓毒性并发症发生率高于LTCBDE组（20% vs 7.5%, P = .105）。LTCBDE组恢复ADL的时间更短（33.4天vs 39.75天，P = 0.007）。糖尿病独立预测术后并发症（调整优势比4.397,P = 0.014）和翻修手术（调整优势比22.592,P = 0.006）。两组复发率相似（P = .363）。结论与LCBDE相比，LTCBDE手术时间短，出血量少，恢复快，术后并发症无增加。LTCBDE可能是治疗胆总管结石的首选方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Practice 医学-外科

CiteScore

0.90

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Surgical Practice is a peer-reviewed quarterly journal, which is dedicated to the art and science of advances in clinical practice and research in surgery. Surgical Practice publishes papers in all fields of surgery and surgery-related disciplines. It consists of sections of history, leading articles, reviews, original papers, discussion papers, education, case reports, short notes on surgical techniques and letters to the Editor.