Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2025; 17(1): 100544
Published online Jan 27, 2025. doi: 10.4240/wjgs.v17.i1.100544
Endoscopic retrograde cholangiopancreatography, endoscopic papillary balloon dilation, and laparoscopic hepatectomy for intra- and extrahepatic bile duct stones
Zhi-Liang Chen, Hong Fu
Zhi-Liang Chen, Hong Fu, Department of Hepatobiliary Surgery, Shaoxing People’s Hospital, Shaoxing 312000, Zhejiang Province, China
Author contributions: Chen ZL designed the research and wrote the first manuscript; Chen ZL and Fu H contributed to conceiving the research and analyzing data; Chen ZL and Fu H 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 Shaoxing People’s Hospital.
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: The authors state that they have no conflicts of interest.
Data sharing statement: No additional data are available.
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: Hong Fu, Associate Chief Physician, Department of Hepatobiliary Surgery, Shaoxing People’s Hospital, No. 568 Zhongxing North Road, Yuecheng District, Shaoxing 312000, Zhejiang Province, China. zjufuhong@163.com
Received: October 9, 2024
Revised: November 12, 2024
Accepted: November 29, 2024
Published online: January 27, 2025
Processing time: 79 Days and 5 Hours
Abstract
BACKGROUND

Intrahepatic and extrahepatic bile duct stones (BDSs) have a high rate of residual stones, a high risk of recurrence, and a high rate of reoperation. It is very important to take timely and effective surgical intervention for patients.

AIM

To analyze the efficacy, postoperative rehabilitation, and quality of life (QoL) of patients with intra- and extrahepatic BDSs treated with endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic papillary balloon dilation (EPBD) + laparoscopic hepatectomy (LH).

METHODS

This study selected 114 cases of intra- and extrahepatic BDSs from April 2021 to April 2024, consisting of 55 cases in the control group receiving laparoscopic common bile duct exploration and LH and 59 cases in the observation group treated with ERCP + EPBD + LH. Efficacy, surgical indicators [operation time (OT) and intraoperative blood loss (IBL)], postoperative rehabilitation (time for body temperature to return to normal, time for pain relief, and time for drainage to reduce jaundice), hospital stay, medical expenses, and QoL [Gastrointestinal Quality of Life Index (GIQLI)] were comparatively analyzed. Further, Logistic regression analysis was conducted to analyze factors influencing the QoL of patients with intra- and extrahepatic BDSs.

RESULTS

The data demonstrated a higher overall effective rate in the observation group compared to the control group (P = 0.011), together with notably reduced OT, less IBL, shorter body temperature recovery time, pain relief time, time for drainage to reduce jaundice, and hospital stay (all P < 0.05). The postoperative GIQLI of the observation group was more significantly increased compared to the control group (P < 0.05). The two groups demonstrated no marked difference in medical expenses (P > 0.05).

CONCLUSION

The above indicates that ERCP + EPBD + LH is effective in treating patients with intra- and extrahepatic BDSs, which is conducive to postoperative rehabilitation and QoL improvement, with promising prospects for clinical promotion.

Keywords: Intra- and extrahepatic bile duct stones; Efficacy; Postoperative rehabilitation; Quality of life; Endoscopic retrograde cholangiopancreatography; Endoscopic papillary balloon dilation

Core Tip: Failure to receive timely and effective surgical intervention may cause massive invasion of the biliary tract by infectious substances in patients with both intra- and extrahepatic bile duct stones (BDSs), subsequently inducing obstructive suppurative cholangitis and liver abscesses, thereby posing a severe threat to life and health. This study analyzed the efficacy, surgical parameters, postoperative rehabilitation, hospital stay, medical expenses, and quality of life (QoL) of patients with intra- and extrahepatic BDSs treated with endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic papillary balloon dilation (EPBD) + laparoscopic hepatectomy (LH). The ERCP + EPBD + LH approach has been confirmed to exhibit a remarkable therapeutic effect in patients with intra- and extrahepatic BDSs, facilitating postoperative recovery and improving the QoL, thereby meriting clinical application and popularization.