Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2024; 16(3): 759-767
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.759
Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones
Wei Wang, Hui Xia, Bin Dai
Wei Wang, Hui Xia, Bin Dai, Department of Hepatobiliary Surgery, Wuhan No.1 Hospital, Wuhan 430030, Hubei Province, China
Co-first authors: Wei Wang and Hui Xia.
Author contributions: Wang W and Xia H contributed equally to this work and are co-first authors; Wang W and Xia H designed the research and wrote the first manuscript; Wang W, Xia H and Dai B contributed to conceiving the research and analyzing data; Wang W and Xia H conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Supported by 2021 Municipal Health Commission Scientific Research Project, No. WX21D48; 2021 Municipal Health Commission Project, No. WZ21Q11; and 2022 Hubei Provincial Department of Science and Technology Project, No. 2022CFB980.
Institutional review board statement: This study was approved by the Ethic Committee of Wuhan No.1 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: There is no conflict of interest.
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: Bin Dai, PhD, Doctor, Department of Hepatobiliary Surgery, Wuhan No.1 Hospital, No. 215 ZhongShan Street, Wuhan 430030, Hubei Province, China. drdbmd@163.com
Received: December 12, 2023
Peer-review started: December 12, 2023
First decision: January 2, 2024
Revised: January 15, 2024
Accepted: February 28, 2024
Article in press: February 28, 2024
Published online: March 27, 2024
ARTICLE HIGHLIGHTS
Research background

Currently, surgery is still the main treatment for intrahepatic and extrahepatic bile duct stones (BDSs), but the success rate of surgery is unsatisfactory and there is a certain risk of postoperative complications.

Research motivation

It is necessary to optimize the surgical treatment of intrahepatic and extrahepatic BDSs, which is of great significance for improving the treatment experience of such patients.

Research objectives

This study was conducted to clarify the clinical advantages of dual-modality endoscopy (duodenoscopy and laparoscopy) over traditional laparotomy in the treatment of intrahepatic and extrahepatic BDSs.

Research methods

Ninety-five patients with intrahepatic and intrahepatic BDSs were included. The control group (n = 45) received traditional laparotomy and the research group (n = 50) received dual-modality endoscopy (duodenoscopy and laparoscopy). The efficacy, safety, surgical indexes, serum inflammatory indexes, oxidative stress indicators, etc. of the two groups were collected for comparative analysis.

Research results

Compared with the control group, the total effective rate was significantly higher in the research group and the postoperative complication rate was statistically lower. In addition, shorter operation time, smaller intraoperative bleeding volume, faster gastrointestinal function recovery, and less hospitalization time were determined in the research group. Moreover, the research group showed more significant improvements in serum inflammation indexes and alleviation of oxidative stress.

Research conclusions

Compared with traditional laparotomy, dual-modality endoscopy is more effective in the treatment of intrahepatic and extrahepatic BDSs with a lower risk of postoperative complications, which can significantly reduce operation time, gastrointestinal function recovery time, hospital stay, and intraoperative blood loss, while effectively inhibiting serum hyperinflammation and causing less postoperative stress responses.

Research perspectives

Duodenoscopy combined with laparoscopy has higher efficacy and safety than traditional laparotomy in patients with extrahepatic and extrahepatic BDSs. However, this study has some limitations, such as limited cases included, being a single-center experience, and failure to include analysis related to factors affecting prognosis, efficacy and safety, which need to be gradually addressed in future studies.