Laparoscopic versus open hepatectomy in the treatment of recurrent hepatobiliary stones
10.3760/cma.j.issn.1007-631X.2017.05.013
- VernacularTitle:腹腔镜与开放肝切除治疗复发性肝胆管结石的比较研究
- Author:
Siming ZHENG
;
Xinhua ZHOU
;
Caide LU
;
Hong LI
- Keywords:
Cholelithiasis;
Reoperation;
Laparoscopes
- From:
Chinese Journal of General Surgery
2017;32(5):421-424
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare laparoscopic hepatectomy to open surgery in recurrent hepatolithiasis.Methods From Jan 2014 to Feb 2016,106 cases of recurrent hepatolithiasis eligible for hepatectomy were prospectively randomized into laparoscopic group (53cases) and open group (53 cases).The perioperative variables,postoperative morbidity and outcomes were analyzed and compared between the 2 groups.Results The statistical results show that the laparoscopic group and open group had similar intraoperative rate of blood loss ＞400 ml,wound infection,abdominal infection,Grade B bile leakage,score of Clavien classification system,stone clearance rate and hospitalization cost (P ＞ 0.05).The laparoscopy group had longer operation time (P ＜ 0.05),and shorter postoperative hospital stay (P ＜0.05).Binary logistic analysis showed that decreased preoperative platelet count,longer operation time,and hepatectomy in difficult places are risk factors for intraoperative blood loss ＞ 400 ml (OR ＞ 1,P ＜0.05);type of past biliary tract operation,positive bile culture during surgery and residual stones are risk factors for grade B bile leakage (OR ＞ 1,P ＜ 0.05).Conclusions Laparoscopic hepatectomy for recurrent hepatolithiasis is safe and feasible.
