Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2080-2087
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2080
Clinical efficacy of laparoscopic cholecystectomy plus cholangioscopy for the treatment of cholecystolithiasis combined with choledocholithiasis
Chao-Hui Liu, Zhi-Wei Chen, Zhe Yu, Hong-Yu Liu, Jian-Sheng Pan, Shuang-Shuang Qiu
Chao-Hui Liu, Zhi-Wei Chen, Hong-Yu Liu, Jian-Sheng Pan, Shuang-Shuang Qiu, Department of General Surgery, The Affiliated Haixia Hospital of Huaqiao University (910th Hospital of Joint Logistic Support Force), Quanzhou 362000, Fujian Province, China
Zhe Yu, Department of General Surgery, Anxi Hospital of Traditional Chinese Medicine, Quanzhou 362499, Fujian Province, China
Author contributions: Liu CH designed the research and wrote the first manuscript; Liu CH, Chen ZW, Yu Z, Liu HY, Pan JS and Qiu SS contributed to conceiving the research and analyzing data; Liu CH conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of 910th Hospital of Joint Logistic Support Force.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Dr. Liu has nothing to disclose.
Data sharing statement: All data and materials are available from the corresponding author.
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: Chao-Hui Liu, BMed, Doctor, Department of General Surgery, The Affiliated Haixia Hospital of Huaqiao University (910th Hospital of Joint Logistic Support Force), No. 180 Huayuan Road, Fengze District, Quanzhou 362000, Fujian Province, China. liuchaohui1983@163.com
Received: February 29, 2024
Revised: May 10, 2024
Accepted: June 7, 2024
Published online: July 27, 2024
Processing time: 144 Days and 3.6 Hours
Abstract
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 (910th 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-α (TNF-α), 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-α, 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.

Keywords: Laparoscopic common bile duct exploration; Endoscopic retrograde cholangiopancreatography; Laparoscopic cholecystectomy; Cholecystolithiasis; Choledocholithiasis; Clinical efficacy

Core Tip: Choledocholithiasis occurs in 10%–18% of patients with cholecystolithiasis. At present, the main treatment for cholecystolithiasis combined with choledocholithiasis is endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC). However, this treatment has several disadvantages. In this study, the treatment outcomes of patients with cholecystolithiasis combined with choledocholithiasis were compared after LC + laparoscopic common bile duct exploration (LCBDE) vs ERCP + LC + LCBDE. Clinical efficacy was better ERCP + LC, patient recovery was accelerated, and surgical risks, postoperative complications, and serum inflammatory factors were lower after LC + LCBDE compared with ERCP + LC.