Laparoscopic vs open surgery for complex hepatolithiasis: A retrospective comparative study

Table 1 Baseline demographic and clinical characteristics of patients undergoing laparoscopic vs open surgery for complex hepatolithiasis, n (%)

Variable	Laparoscopic group (n = 40)	Open surgery group (n = 40)	χ2/t/Mann-Whitney U test	P value
Age (years, mean ± SD), (range)	52.7 ± 12.1 (23.0-81.0)	56.1 ± 12.9 (34.0-80.0)	-1.215	0.228
Sex
Female	24 (60.0)	26 (65.0)	0.213	0.644
Male	16 (40.0)	14 (35.0)	-	-
BMI (kg/m2, IQR)	20.0 (18.0-21.0)	20.0 (19.0-22.5)	-0.998	0.318
Hepatitis B	8 (20.0)	7 (17.5)	0.082	0.775
Malnutrition	6 (15.0)	8 (20.0)	0.346	0.556
Diabetes	6 (15.0)	7 (17.5)	0.092	0.762
Presentation
Acute cholangitis	37 (92.5)	36 (90.0)	-	1.0001
Acute pancreatitis	9 (22.5)	8 (20.0)	0.075	0.785
Liver abscess	12 (30.0)	15 (37.5)	0.503	0.478
Lung abscess	2 (5.0)	1 (2.5)	-	1.0001
Previous operation
Cholecystectomy	34 (85.0)	35 (87.5)	0.105	0.745
Bilioenteric anastomosis	7 (17.5)	7 (17.5)	0.000	1.000
Exploration of bile duct	35(87.5)	33 (82.5)	0.392	0.531
Hepatectomy	10 (25.0)	11 (27.5)	0.065	0.799
Concomitant condition
Gallbladder stones	3 (7.5)	4 (10.0)	-	1.0001
Extrahepatic biliary stones	34 (85.0)	33 (82.5)	0.092	0.762
Hepatic atrophy	12 (30.0)	15 (37.5)	0.503	0.478
Cirrhosis	6 (15.0)	7 (17.5)	0.092	0.762
Intrahepatic biliary stricture	38 (95.0)	38 (95.0)	-	1.0001

¹Fisher’s exact test.

BMI: Body mass index; IQR: Interquartile range.

Table 2 Comparison of intraoperative parameters, postoperative outcomes, and complications between the laparoscopic and open surgery groups, n (%)

Variables	Laparoscopic group (n = 40)	Open surgery group (n = 40)	χ2/Mann-Whitney U test	P value
Left lateral sectionectomy	5 (12.5)	5 (12.5)	0.000	1.000
Periportal hepatectomy	3 (7.5)	3 (7.5)	-	1.0001
Left hepatectomy	6 (15.0)	3 (7.5)	-	0.4811
Right posterior segmentectomy	5 (12.5)	6 (15.0)	0.105	0.745
Right hepatectomy	4 (10.0)	4 (10.0)	-	1.0001
Left lateral sectionectomy + hilar cholangioplasty	6 (15.0)	7 (17.5)	0.092	0.762
Periportal hepatectomy + bilioenteric anastomosis	4 (10.0)	4 (10.0)	-	1.0001
Periportal hepatectomy + hilar cholangioplasty	7 (17.5)	8 (20.0)	0.082	0.775
Surgical time (minutes)	250.0 (215.0-315.0)	207.0 (185.8-255.0)	-2.984	0.003
Intraoperative blood loss (mL, IQR)	290.0 (200.0-350.0)	300.0 (250.0-450.0)	-0.791	0.429
Pringle maneuver time (minutes, IQR)	35.0 (30.0-45.0)	38.0 (25.0-45.0)	-0.445	0.656
Postoperative hospital stay (days, IQR)	9.0 (8.0-11.0)	14.0 (12.0-17.0)	-5.545	< 0.001
Stone clearance	31 (77.5)	32 (80.0)	0.075	0.785
Choledochoscopic stone removal via T-canal sinus	9 (22.5)	8 (20.0)	0.075	0.785
Final stone clearance	33 (82.5)	34 (85.0)	0.092	0.762
Complications	17 (42.5)	18 (45.0)	0.051	0.822
Complication types
Intra-abdominal bleeding	3 (7.5)	3 (7.5)	-	1.0001
Biliary leakage	3 (7.5)	4 (10.0)	-	1.0001
Wound infection	2 (5.0)	9 (22.5)	5.165	0.023
Pulmonary infection	3 (7.5)	5 (12.5)	-	0.7121
Pleural effusion	8 (20.0)	10 (25.0)	0.287	0.592
Abdominal infection	3 (7.5)	6 (15.0)	-	0.4811
Subphrenic abscess	1 (2.5)	2 (5.0)	-	1.0001
Residual stones	7 (17.5)	8 (15.0)	0.092	0.762

¹Fisher’s exact test.

IQR: Interquartile ranges.

Table 3 Postoperative follow-up outcomes in the laparoscopic and open surgery groups, n (%)

Variable	Laparoscopic group (n = 40)	Open surgery group (n = 40)	χ2/ Mann-Whitney U test	P value
Follow-up duration (months), mean ± SD	28.0 (20.0-30.8)	28.5 (24.0-40.5)	-0.947	0.344
Stone recurrence	10 (25.0)	7 (17.5)	0.672	0.412
Cholangitis	8 (20.0)	10 (25.0)	0.287	0.592
Cholangiocarcinoma	3 (7.5)	3 (7.5)	-	1.0001
Mortality	0 (0.0)	1 (2.5)	-	1.0001

¹Fisher’s exact test.