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Laparoscopic common bile duct exploration for patients with a history of prior biliary surgery: a comparative study with an open approach
Author(s) -
Zhu Jisheng,
Du Peng,
He Jianpeng,
Tong Fengxiong,
Xiao Weidong,
Li Yong
Publication year - 2021
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.16529
Subject(s) - medicine , common bile duct , blood loss , surgery , complication , bile duct , open surgery , laparoscopy , laparoscopic surgery , common bile duct stone , general surgery
Background Laparoscopic common bile duct exploration (LCBDE) is increasingly being used to treat choledocholithiasis. However, few studies have examined the treatment of recurrent common bile duct stones (CBDS) in patients with a history of prior biliary surgery. The current research aimed to compare the outcomes of laparoscopic versus open common bile duct exploration in patients with a history of prior biliary surgery. Methods Between March 2010 and August 2019, 162 patients with recurrent CBDS after prior biliary surgery who underwent surgical management in our institution were enrolled in this study. The demographic, intraoperative and postoperative data were retrospectively analysed. Results Among these 162 patients, 72 underwent laparoscopic approach (LCBDE group), and 90 underwent open surgery (open common bile duct exploration group). The LCBDE group was associated with significantly lower overall complication rate, incision infection rate and blood loss compared to open common bile duct exploration group (all P < 0.05). Moreover, the laparoscopic approach significantly reduced the length of postoperative hospital stay ( P < 0.05). However, the operative time, stone clearance rate, and stone recurrence rate were not significantly different between the two groups ( P > 0.05). The conversion rate of the laparoscopic approach was 6.9%. Conclusions LCBDE is superior to open procedure in terms of blood loss, hospital stay, overall complication and incision infection in patients with a history of prior biliary surgery, and it should be considered as a safe and effective treatment if it is performed by an experienced surgeon.