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2024 ; 16
(7
): 2080-2087
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Clinical efficacy of laparoscopic cholecystectomy plus cholangioscopy for the
treatment of cholecystolithiasis combined with choledocholithiasis
#MMPMID39087102
Liu CH
; Chen ZW
; Yu Z
; Liu HY
; Pan JS
; Qiu SS
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2080-2087
PMID39087102
show ga
BACKGROUND: Currently, endoscopic retrograde cholangiopancreatography (ERCP) plus
laparoscopic cholecystectomy (LC) is the main treatment for cholecystolithiasis
combined with choledocholithiasis. However, the treatment is unsatisfactory, and
the development of better therapies is needed. AIM: To determine the clinical
efficacy of LC plus cholangioscopy for cholecystolithiasis combined with
choledocholithiasis. METHODS: Patients (n = 243) with cholecystolithiasis and
choledocholithiasis admitted to The Affiliated Haixia Hospital of Huaqiao
University (910(th) Hospital of Joint Logistic Support Force) between January
2019 and December 2023 were included in the study; 111 patients (control group)
underwent ERCP + LC and 132 patients (observation group) underwent LC +
laparoscopic common bile duct exploration (LCBDE). Surgical success rates,
residual stone rates, complications (pancreatitis, hyperamylasemia, biliary tract
infection, and bile leakage), surgical indicators [intraoperative blood loss
(IBL) and operation time (OT)], recovery indices (postoperative
exhaust/defecation time and hospital stay), and serum inflammatory markers
[C-reactive protein (CRP), tumor necrosis factor-? (TNF-?), and interleukin-6
(IL-6) were compared. RESULTS: No significant differences in surgical success
rates and residual stone rates were detected between the observation and control
groups. However, the complication rate, IBL, OT, postoperative exhaust/defecation
time, and hospital stays were significantly reduced in the observation group
compared with the control group. Furthermore, CRP, TNF-?, and IL-6 Levels after
treatment were reduced in the observation group compared with the levels in the
control group. CONCLUSION: These results indicate that LC + LCBDE is safer than
ERCP + LC for the treatment of cholecystolithiasis combined with
choledocholithiasis. The surgical risks and postoperative complications were
lower in the observation group compared with the control group. Thus, patients
may recover quickly with less inflammation after LCBDE.