A new operation for gallstones: Choledochoscopic gallbladder-preserving cholecystolithotomy, a retrospective study of 3,511 cases

Liu, Jingshan; Zhu, Xingyi; Zhao, Qikang; Huang, Kunquan; Zhou, Daixing; Zhang, Xiaolin; Gao, Zhaoya; Liu, Siyao; Gu, Jin

doi:10.1016/j.surg.2022.08.008

Cited by 5 publications

(5 citation statements)

References 35 publications

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“…Laparoscopic cholecystostomy is a current surgical method for gallstones that retains the advantages of the gallbladder and its function ( 1 ). However, the puncture hole of the abdominal wall and the traction of the viscera induced pain and stress, reaching a VAS score of 4 points postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Active shoulder pain Oxycodone 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 Sufentanil 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 0.0 (0) .0 response in patients undergoing laparoscopic cholecystolithotomy than sufentanil. Laparoscopic cholecystostomy is a current surgical method for gallstones that retains the advantages of the gallbladder and its function (1). However, the puncture hole of the abdominal wall and the traction of the viscera induced pain and stress, reaching a VAS score of 4 points postoperatively.…”

Section: Groupmentioning

confidence: 99%

“…At present, it is believed that it mainly consists of three parts: incision pain, visceral pain, and shoulder pain. Bile flow into the abdominal cavity caused by the operation may aggravate visceral pain and infection ( 1 ). The high clinical incidence of physical pain imposes a substantial burden on society; however, as attention gradually shifts toward visceral pain, it has been found that it causes an even greater social burden.…”

Section: Introductionmentioning

confidence: 99%

“…This surgical approach not only preserves gallbladder function but also greatly reduces trauma, significantly improving the quality of life of patients after surgery. Thus, it has become one of the main clinical treatments for gallstones (1)(2)(3)(4). Although this method has certain advantages such as quick recovery and a shorter hospital stay, 30%-70% of patients experience significant pain following the procedure leading to atelectasis and sympathetic hyperactivity (5,6).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the analgesic effects of oxycodone vs. sufentanil on postoperative pain after laparoscopic gallbladder-preserving cholecystolithotomy: a prospective randomized controlled trial

Wang,

Wu,

Zhao

et al. 2024

Front. Surg.

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BackgroundWe aimed to compare the anesthesia induction effects of oxycodone and sufentanil on postoperative pain in patients undergoing laparoscopic gallbladder-preserving cholecystolithotomy, as well as changes in serum levels of inflammatory factors (TNF-α, IL-6, and IL-10) in the perioperative period.MethodsSixty patients who underwent laparoscopic gallbladder-preserving cholecystolithotomy were evenly divided into oxycodone (O) and sufentanil (S) groups. In groups O and S, oxycodone (0.3 mg/kg) and sufentanil (0.3 ug/kg) were administered, respectively, followed by propofol (2 mg/kg) and rocuronium (0.6 mg/kg). In both groups, the intraoperative electroencephalography double-frequency index was used to guide the use of sedative and analgesic drugs, assessing the follow-up analgesic effect (VAS), degree of sedation (Ramsey), and postoperative complications at seven different time points (0, 0.5, 2, 4, 6, 8, and 24 h postoperatively).ResultsCompared with the S group, patients in the O group exhibited lower VAS scores within 24 h postoperatively (P < 0.001), but there was no statistical difference between wound and shoulder pain scores (P > 0.05). Regarding postoperative awakening and extubation duration, O group patients experienced shorter times and better remedial analgesia (P < 0.05). In terms of the degree of sedation, the Ramsay score decreased at 0 h postoperatively compared with the S group (P < 0.001).ConclusionCompared with sufentanil, oxycodone anesthesia induced better postoperative analgesia and less inflammatory responses in patients undergoing laparoscopic gallbladder-preserving cholecystolithotomy.Clinical Trial RegistrationThis study has been approved by the Ethics Committee of Peking University Shougang Hospital, with ethical approval (No. IRBK-2020-009), and has completed registration in the Chinese Clinical Trials Register (http://www.chictr.org.cn/) (ChiCTR2000031230).

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Section: Discussionmentioning

confidence: 99%

Section: Groupmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the analgesic effects of oxycodone vs. sufentanil on postoperative pain after laparoscopic gallbladder-preserving cholecystolithotomy: a prospective randomized controlled trial

Wang,

Wu,

Zhao

et al. 2024

Front. Surg.

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“…It has been indicated by related data that the recurrence rate at 1–2 years after gallbladder-preserving cholecystolithotomy can reach 30% or even higher [ 16 ]. This is because the surgical treatment fails to fundamentally change the environment in which gallstones are easily formed, and the internal structure of the gallbladder cannot be directly observed during previous laparoscopic gallbladder-preserving cholecystolithotomy, where the small stone debris is easily omitted [ 17 ]. It was discovered through this study that the recurrence rate at 6 months after operation was 1.92% in the laparoscopic + choledochoscopic group, lower than that in the laparoscopic group (14.58%), implying that laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy also has some advantages in lowering the risk of postoperative recurrence, which is related to the operative visual field being improved by choledochoscopy as well.…”

Section: Discussionmentioning

confidence: 99%

Effects of laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy on levels of operation indicators, gallbladder function, and cholecystokinin type-A receptor in patients with gallstones.

Zhang,

Feng,

Cai

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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Introduction: Gallstones are a common digestive system disease. Aim: To assess the effects of laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy on the levels of operation indicators, gallbladder function, and cholecystokinin type-A receptor (CCKAR) in patients with gallstones. Material and methods:The medical records of 100 patients with gallstones receiving operation from July 2019 to August 2022 were collected for retrospective analysis. They were divided into a laparoscopic group (n = 48) and a laparoscopic + choledochoscopic group (n = 52). The laparoscopic group received totally laparoscopic cholecystolithotomy, while the laparoscopic + choledochoscopic group underwent laparoscopic and choledochoscopic cholecystolithotomy. Their perioperative indicators, gallbladder function, stress indicators (cortisol (Cor), norepinephrine (NE), and C-reactive protein (CRP)), serum biochemical indicators (liver receptor homologue 1 (LRH-1), CCKAR, and vasoactive intestinal peptide (VIP)), and complications were compared.Results: The fasting gallbladder volume and gallbladder contraction rate increased, and the minimum residual volume and gallbladder wall thickness decreased in the laparoscopic + choledochoscopic group in comparison with those of the laparoscopic group 6 months after operation (p < 0.05). The levels of serum Cor, NE, CRP, and CCKAR were elevated, whereas the levels of serum LRH-1 and VIP were lowered in both groups 3 d after operation compared with those before operation (p < 0.05). The levels of serum Cor, NE, CRP, LRH-1, and VIP were lower, and the level of serum CCKAR was higher in the laparoscopic + choledochoscopic group than those in the laparoscopic group 3 d after operation (p < 0.05). Conclusions: Both laparoscopic gallbladder-preserving cholecystolithotomy and laparoscopic and choledochoscopic cholecystolithotomy are effective for treating gallstones. However, the latter combination method is superior in enhancing postoperative gallbladder function, decreasing the recurrence risk, regulating the expressions of LRH-1, CCKAR, and VIP, and promoting the postoperative recovery of gastrointestinal function.

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Feasibility of gallbladder lesion visualization using a novel ultrafine peroral cholangioscopy: A preliminary investigation

Zhou,

Shen,

et al. 2024

Digestive and Liver Disease

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A new operation for gallstones: Choledochoscopic gallbladder-preserving cholecystolithotomy, a retrospective study of 3,511 cases

Cited by 5 publications

References 35 publications

Comparison of the analgesic effects of oxycodone vs. sufentanil on postoperative pain after laparoscopic gallbladder-preserving cholecystolithotomy: a prospective randomized controlled trial

Comparison of the analgesic effects of oxycodone vs. sufentanil on postoperative pain after laparoscopic gallbladder-preserving cholecystolithotomy: a prospective randomized controlled trial

Effects of laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy on levels of operation indicators, gallbladder function, and cholecystokinin type-A receptor in patients with gallstones.

Feasibility of gallbladder lesion visualization using a novel ultrafine peroral cholangioscopy: A preliminary investigation

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