Clinical analysis of laparoscopic transcystic common bile duct exploration combined confluence microdissection or balloon dilatation at the cystic duct in day surgery laparoscopic cholecystectomy
10.16139/j.1007-9610.2025.04.08
- VernacularTitle:日间腹腔镜胆囊切除术中经胆囊管胆道镜探查联合汇入部微切开或球囊扩张的临床分析
- Author:
Hongwei WU
;
Kuinan TONG
;
Haonan LI
;
Dong WANG
;
Kun LIU
;
Wei GUO
- Publication Type:Journal Article
- From:
Journal of Surgery Concepts & Practice
2025;30(4):339-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and efficacy of combined confluence microdissection or balloon dilatation followed by laparoscopic transcystic common bile duct exploration (LTCBDE) in day surgery laparoscopic cholecystectomy. Methods The clinical data of 203 patients with day surgery laparoscopic cholecystectomy combined with LTCBDE from June 2021 to June 2024 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. They were divided into an observation group (59 cases, including 42 cases of confluent microdissection and 17 cases of balloon dilatation) and a conventional group (144 cases) according to the surgical technique used. Baseline characteristics, intraoperative exploration results, operation time, postoperative recovery and complications were compared between the two groups. Results The history of preoperative cholangitis or pancreatitis (P<0.001) was more common in the observation group. And total bilirubin level was significantly higher in the observation group than in the conventional group (P=0.035). The observation group had a longer operative time (P=0.014) and higher hospitalization costs (P=0.001), but there was no difference in intraoperative bleeding and postoperative discharge time. There were no serious postoperative complications in either group. Conclusions Under the premise of strict patient screening, day surgery LTCBDE combined with confluence microdissection or balloon dilatation can effectively solve the problem of difficult choledochoscopic access, with high safety and thoroughness of exploration. Both techniques provide a feasible minimally observation solution for day surgery biliary exploration.
