Differences in Outcome and Comparison of Stress and Immune Status in Patients with Recurrent Common Bile Duct Stones after Biliary Tract Surgery Choosing Three Procedures (ERCP, OCBDE, and LCBDE) for Treatment

Abstract

Objective. To compare the effect of choosing ERCP, OCBDE, and LCBDE for the treatment of patients with recurrent common bile duct stones after biliary tract surgery. Method. 115 patients with recurrent common bile duct stones after biliary surgery in our hospital were retrospectively analyzed and divided into three groups according to the procedure, 36 patients in the ERCP group, 38 patients in the OCBDE group, and 41 patients in the LCBDE group, and compared the efficacy, stress status, and immune status of the three groups. Result. The stone removal rates were 91.67%, 97.37%, and 97.56% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). There were statistical differences between the ERCP, OCBDE, and LCBDE groups in terms of operative time, postoperative recovery time of exhaustion, recovery time of defecation, recovery time of feeding, and hospitalization time ( P < 0.05 ). The postoperative complication rates were 8.33%, 10.53%, and 7.32% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). The recurrence rates within 1 year after surgery were 2.78%, 7.89%, and 2.44% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). Conclusion. ERCP has short operative time, short hospital stay, and rapid postoperative recovery. LCBDE has mild trauma, and OCBDE has a wide range of application. Each of the three procedures has its own advantages and shortcomings, and the most appropriate procedure should be selected on the basis of comprehensive evaluation.

Primary closure combined with C-tube drainage through cystic duct after laparoscopic common bile duct exploration is safe and feasible for patients

“…Comparing to OC + OCBDE, ERCP + LC and LC + LCBDE are more minimally invasive. ERCP + LC requires two procedures, while LC + LCBDE is a single-stage surgery ( 7 , 13 ). The guideline published in 2017 had proposed in the guidelines for the management of CBDS that LCBDE and ERCP were both very successful in removing CBDS, although there is no evidence that LCBDE differs from ERCP in terms of efficacy, mortality or morbidity, LCBDE and ERCP are considered as two equally effective treatment options.…”

“…Complications of LCBDE are mainly related to common bile duct resection (biliary leakage) and T-tube use (biliary leakage, tube displacement). Postoperative biliary leakage will cause a serious of sequelae, such as biliary peritonitis, bacterial infection in abdominal cavity, electrolyte imbalance, and even requires reoperation in severe cases ( 4 , 13 ). In order to avoid postoperative bilary leakage, T-tube is routinely placed for drainage after LCBDE.…”

“…Usually, there are spiral-shaped folds (Heister valves) at the junction between the cystic duct and the common bile duct, which will be the barrier for C-tube insertion ( 22 ). Inserting C-tube through cystic duct with Laparoscope is a delicate process that requires proficient surgical skills, therefore, we recommend that this type of surgery should be performed by professional hepatobiliary surgeons, meanwhile, surgeons are encouraged to attend the training of LCBDE to reduce the chances that they may seek for help when dealing with difficult CBD stones ( 13 ). Our experiences from this study including ( Figure 3 ): 1.…”

Meta-analysis of the timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in patients with cholecystolithiasis and choledocholithiasis

“…In recent years, with the aging of the population, and the changes in diet structure and lifestyle, the incidence has been on the rise [1]. Surgery is the main treatment method for cholecystolithiasis combined with choledocholithiasis, but traditional open surgery has many limitations [2]. In recent years, minimally invasive has become the main method of treatment, with fewer postoperative complications, less trauma, faster recovery, and other advantages [3,4].…”

Retracted: Differences in Outcome and Comparison of Stress and Immune Status in Patients with Recurrent Common Bile Duct Stones after Biliary Tract Surgery Choosing Three Procedures (ERCP, OCBDE, and LCBDE) for Treatment

“…Computational and Mathematical Methods in Medicine has retracted the article titled “Differences in Outcome and Comparison of Stress and Immune Status in Patients with Recurrent Common Bile Duct Stones after Biliary Tract Surgery Choosing Three Procedures (ERCP, OCBDE, and LCBDE) for Treatment” [ 1 ] due to concerns that the peer review process has been compromised.…”