Synchronous laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration or combined with endoscopic sphincterotomy for gallstones with common bile duct stones
10.3760/cma.j.cn113855-20230617-00324-1
- VernacularTitle:同期腹腔镜胆囊切除联合腹腔镜胆总管探查术或内镜括约肌切开取石术治疗胆囊结石合并胆总管结石的疗效比较
- Author:
Hongliang TIAN
1
;
Dousheng BAI
;
Shengjie JIN
;
Baohuan ZHOU
;
Tianming GAO
;
Guoqing JIANG
Author Information
1. 扬州大学临床医学院肝胆外科,扬州 225001
- Keywords:
Laparoscopy;
Endoscopy;
Common bile duct exploration;
Choledocholithotomy;
Common bile duct stones
- From:
Chinese Journal of General Surgery
2024;39(2):105-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the recurrence of common bile duct stones (CBDS) in patients with gallstones and concurrent CBDS treated by two surgical approaches: synchronous laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) (LC+LCBDE) and synchronous LC combined with intraoperative endoscopic sphincterotomy (IO-EST) (LC+IO-EST).Methods:From Apr 2013 to Apr 2020, the clinical data of 903 patients with gallstones with CBDS who were admitted to the Clinical Medical College, Yangzhou University were retrospectively analyzed.Results:Based on the chosen surgical method, we categorized 389 cases into group A (LC+LCBDE) and 514 cases into group B (LC+IO-EST). Our findings revealed that group A had a significantly lower rate of CBDS recurrence and re-recurrent CBDS compared to group B (4.4% vs. 8.4%, P=0.024; 0.8% vs. 3.1%, P=0.010). Moreover, Logistic regression analysis after inverse probability of treatment weighting, revealed that the surgical approach implemented in group A was an independent protective factor of recurrent CBDS and second recurrence of CBDS ( OR=0.482, 95% CI: 0.365-0.637, P<0.001; OR=0.118, 95% CI:0.080-0.173, P<0.001). Conclusion:LC+LCBDE is an optimal treatment option to LC+IO-EST for patients with gallstones combined with CBDS and common bile duct ≥8 mm.
