Liao JH, Li JS, Wang TL, Liu WS. Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrence-associated risk factors. World J Gastrointest Surg 2024; 16(11): 3511-3519 [PMID: 39649185 DOI: 10.4240/wjgs.v16.i11.3511]
Corresponding Author of This Article
Jia-Hua Liao, MMed, Attending Doctor, Department of Hepatobiliary Surgery, Shaoyang Central Hospital, No. 36 Qianyuan Lane, Hongqi Road, Shaoyang 422000, Hunan Province, China. 15773969392@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2024; 16(11): 3511-3519 Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3511
Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrence-associated risk factors
Jia-Hua Liao, Ju-Shi Li, Tie-Long Wang, Wen-Shen Liu
Jia-Hua Liao, Ju-Shi Li, Wen-Shen Liu, Department of Hepatobiliary Surgery, Shaoyang Central Hospital, Shaoyang 422000, Hunan Province, China
Tie-Long Wang, Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Liao JH designed and performed the research and wrote the paper; Liao JH and Li JS designed the research and supervised the report; Liao JH, Wang TL and Liu WS designed the research and organized the data; Liao JH designed the research and contributed to the analysis. All authors approved the manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Shaoyang Central 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: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The clinical data used in this study can be obtained from the corresponding author upon request at 15773969392@163.com.
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: Jia-Hua Liao, MMed, Attending Doctor, Department of Hepatobiliary Surgery, Shaoyang Central Hospital, No. 36 Qianyuan Lane, Hongqi Road, Shaoyang 422000, Hunan Province, China. 15773969392@163.com
Received: August 26, 2024 Revised: September 26, 2024 Accepted: October 11, 2024 Published online: November 27, 2024 Processing time: 65 Days and 5.9 Hours
Abstract
BACKGROUND
There remain controversies regarding the surgical treatment of extrahepatic bile duct stones (EHBDSs) in clinical practice.
AIM
To explore the curative effect of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE) for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence.
METHODS
Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected. Among them, patients treated with open choledocholithotomy plus LC or open cholecystectomy (OC) were set as the control group (n = 40), and those treated with LC plus CBDE served as the observation group (n = 42). The surgical outcomes of the two groups were compared, the surgical complications and Gastrointestinal Quality of Life Index (GIQLI) scores were counted, and the one-year prognostic recurrence was recorded. Independent factors for postoperative recurrence were determined using univariate and multivariate analyses.
RESULTS
The two groups were comparable in the stone residual rate (P > 0.05). The operation time (P < 0.05), intraoperative bleeding (P < 0.05), and total complication rate (P = 0.005) were lower in the observation group than in the control group. The observation group exhibited a marked increase in the GIQLI score, which was higher than the control group (P < 0.05). A lower one-year recurrence rate was determined in the observation group vs the control group (P = 0.027). Sphincter of Oddi dysfunction [odds ratio (OR) = 5.712, P = 0.007] and the treatment scheme of open choledocholithotomy plus LC or OC (OR = 6.771, P = 0.008) were the independent risk factors for one-year recurrence in patients after surgery.
CONCLUSION
LC plus CBDE for patients with EHBDSs can reduce stone residuals, intraoperative bleeding, complications, and postoperative recurrence.
Core Tip: This research project included 82 patients with extrahepatic bile duct stones (EHBDSs) for a comparative analysis of the clinical advantages of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE) vs open choledocholithotomy plus LC or open cholecystectomy for EHBDSs and an exploration of the risk factors for postoperative stone recurrence. It was found that for patients with EHBDSs, treatment with LC plus CBDE can reduce stone residue and intraoperative bleeding, as well as lower complication and postoperative recurrence rates. Our findings can shed new light on the optimization of treatment for patients with EHBDSs.
