Laparoscopic hepatectomy combined with endoscopic papillary balloon dilation for complex bile duct stones

Yang, Jian; Zhang, Fabiao; Du, Xu; Wang, Aidong; Lv, Shangdong; Fang, Zheping

doi:10.1111/ans.14132

Cited by 1 publication

(1 citation statement)

References 12 publications

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“…For example, Shin et al [ 19 ] reported that the use of peroral cholangioscopy can help identify bile duct neoplastic lesions and guide surgery. In addition, Yang et al [ 20 ] noted in their study that laparoscopic hepatectomy combined with endoscopic papillary balloon dilation is safe and effective in treating complex BDSs and is beneficial due to rapid postoperative recovery and a low risk of complications. As reported by Lv et al [ 21 ], choledochoscopic-guided holmium laser lithotripsy can not only completely remove stones in patients with intractable extra and intrahepatic BDSs but can also prevent postoperative adverse reactions such as biliary tract injury.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones

Wang,

Xia,

Dai

2024

World J Gastrointest Surg

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BACKGROUND Bile duct stones (BDSs) may cause patients to develop liver cirrhosis or even liver cancer. Currently, the success rate of surgical treatment for intrahepatic and extrahepatic BDSs is not satisfactory, and there is a risk of postoperative complications. AIM To compare the clinical effects of dual-modality endoscopy (duodenoscopy and laparoscopy) with those of traditional laparotomy in the treatment of intra- and extrahepatic BDSs. METHODS Ninety-five patients with intra- and extrahepatic BDSs who sought medical services at Wuhan No.1 Hospital between August 2019 and May 2023 were selected; 45 patients in the control group were treated by traditional laparotomy, and 50 patients in the research group were treated by dual-modality endoscopy. The following factors were collected for analysis: curative effects, safety (incision infection, biliary fistula, lung infection, hemobilia), surgical factors [surgery time, intraoperative blood loss (IBL) volume, gastrointestinal function recovery time, and length of hospital stay], serum inflammatory markers [tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-8], and oxidative stress [glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), and advanced protein oxidation products (AOPPs)]. RESULTS The analysis revealed markedly better efficacy (an obviously higher total effective rate) in the research group than in the control group. In addition, an evidently lower postoperative complication rate, shorter surgical duration, gastrointestinal function recovery time and hospital stay, and lower IBL volume were observed in the research group. Furthermore, the posttreatment serum inflammatory marker (TNF-α, IL-6, and IL-8) levels were significantly lower in the research group than in the control group. Compared with those in the control group, the posttreatment GSH-Px, SOD, MDA and AOPPs in the research group were equivalent to the pretreatment levels; for example, the GSH-Px and SOD levels were significantly higher, while the MDA and AOPP levels were lower. CONCLUSION Dual-modality endoscopy therapy (duodenoscopy and laparoscopy) is more effective than traditional laparotomy in the treatment of intra- and extrahepatic BDSs and has a lower risk of postoperative complications; significantly shortened surgical time; shorter gastrointestinal function recovery time; shorter hospital stay; and lower intraoperative bleeding volume, while having a significant inhibitory effect on excessive serum inflammation and causing little postoperative oxidative stress.

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Section: Discussionmentioning

confidence: 99%

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones

Wang,

Xia,

Dai

2024

World J Gastrointest Surg

View full text Add to dashboard Cite

show abstract

Laparoscopic hepatectomy combined with endoscopic papillary balloon dilation for complex bile duct stones

Abstract: LH combined with EPBD applied to intra- and extrahepatic bile duct stones was feasible, effective and safe, resulting in rapid recovery and few post-operative complications.

Cited by 1 publication

References 12 publications

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones

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