摘要
Abstract
Objective To explore the clinical efficacy and safety of laparoscopic micro-incision at the cystic duct confluence with primary closure in the treatment of non-dilated common bile duct stones combined with gallbladder stones.Methods A retrospective analysis was conducted on patients who underwent laparoscopic choledocholithotomy at the Renmin Hospital,Hubei University of Medicine from January 1,2021,to December 31,2023.Patients were divided into an observation group(primary closure for micro-incision,n=49)and a(T-tube drainage,n=51)based on the surgical procedure.Baseline characteristics,perioperative outcomes,preoperative and postoperative liver function parameters,postoperative complications,and follow-up results were compared between the two groups.ResultsNo differences were found in baseline characteristics between the two groups(all P＞0.05).The observation group demonstrated significant advantages over the control group in terms of operation time,time to recovery of gastrointestinal function,duration of postoperative bed rest,du-ration of postoperative drainage at the foramen of Winslow,length of hospital stay,hospitalization costs,alanine amin-otransferase(ALT)on postoperative day 3,incidence of postoperative electrolyte disturbances,incidence of incisional in-flammation,and complete acceptance rate(all P＜0.05).During the 12-month follow-up,there were no recurrences of stones or biliary strictures noted in either group(P＞0.05).Bile leakage occurred in 4 patients in the observation group and in 1 patient in the control group,all of which were effectively managed with adequate drainage.Additionally,no differences were observed between the two groups regarding intraoperative blood loss,aspartate aminotransferase(AST)and total bili-rubin on postoperative day 3,incidence of biliary hemorrhage,or residual stone rates(all P＞0.05).Conclusion It is ef-fective and safe to perform laparoscopic micro-incision at the cystic duct confluence with primary closure for non-dilated common bile duct stones combined with gallbladder stones,which provides faster recovery,fewer complications,and im-proved quality of life.关键词
腹腔镜/胆囊管胆总管汇合部微切开/胆道探查/一期缝合/T管引流Key words
Laparoscopy/Micro-incision at cystic duct confluence/Biliary exploration/Primary closure/T-tube drainage
