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World J Hepatol. Nov 27, 2025; 17(11): 110050
Published online Nov 27, 2025. doi: 10.4254/wjh.v17.i11.110050
Published online Nov 27, 2025. doi: 10.4254/wjh.v17.i11.110050
Laparoscopic vs open surgery for complex hepatolithiasis: A retrospective comparative study
De-Xin Lin, Xin-Bin Zhuo, Gui-Jian Chang, Wen-De Lei, Jian Huang, Yong Zhang, Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde 352100, Fujian Province, China
De-Xin Lin, Xin-Bin Zhuo, Gui-Jian Chang, Wen-De Lei, Jian Huang, Yong Zhang, Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde 352100, Fujian Province, China
Zheng-Jun Qiu, General Surgery Center, The First People’s Hospital Affiliated with Shanghai Jiao Tong University, Shanghai 200080, Shanghai Province, China
Shi-Yan Zhang, Department of Clinical Laboratory, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
Co-corresponding authors: De-Xin Lin and Shi-Yan Zhang.
Author contributions: Lin DX conceptualized and designed the study, performed surgical procedures, and critically revised it for intellectual content; Zhuo XB assisted in surgical interventions, managed postoperative patient follow-up, and contributed to clinical data acquisition; Chang GJ conducted literature reviews, ensured ethical compliance, and contributed to manuscript preparation and editing; Lei WD participated in data curation, preoperative patient assessments; Huang J supervised the study, interpreted imaging and clinical data, and provided critical revisions to the manuscript; Zhang Y provided technical expertise in intraoperative imaging and visualization techniques; Qiu ZJ and Zhang SY conducted data collection, statistical analysis, and interpretation of the results; Lin DX, Lei WD, and Zhang SY drafted the manuscript; Lin DX and Zhang SY contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Fujian Natural Science Foundation, China, No. 2021J011164.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Ningde Municipal Hospital, Ningde Normal University, approval No. 20211009.
Informed consent statement: Informed consent was acquired from all study participants and/or their legal guardians.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Xin Lin, MD, Director, Professor, Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, No. 13 Mindong East Road, Jiaocheng District, Ningde 352100, Fujian Province, China.
Received: May 28, 2025
Revised: June 18, 2025
Accepted: October 9, 2025
Published online: November 27, 2025
Processing time: 183 Days and 1.5 Hours
Revised: June 18, 2025
Accepted: October 9, 2025
Published online: November 27, 2025
Processing time: 183 Days and 1.5 Hours
Core Tip
Core Tip: This retrospective study compares laparoscopic and open surgical approaches for complex hepatolithiasis, a challenging condition involving intrahepatic bile duct stones and anatomical distortions. Despite a longer operative time, laparoscopic surgery resulted in significantly shorter hospital stays and lower wound infection rates, while maintaining similar stone clearance and complication rates. The study highlights the feasibility and safety of minimally invasive liver surgery in high-risk patients when performed under strict adherence to surgical indication selection criteria, skillful utilization of anatomical characteristics of Laennec’s capsule of the liver, and standardized operative protocols.