Laparoscopic Approach for Right-Sided Intrahepatic Duct Stones: A Comparative Study of Laparoscopic Versus Open Treatment

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• 作者：Young Ki Kim ; Ho-Seong Han ; Yoo-Seok Yoon ; Jai Young Cho…
• 刊名：World Journal of Surgery
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：39
• 期：5
• 页码：1224-1230
• 全文大小：446 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Cardiac Surgery
  General Surgery
  Thoracic Surgery
  Vascular Surgery
  
• 出版者：Springer New York
• ISSN：1432-2323

文摘

Background Despite several attempts to treat intrahepatic duct (IHD) stones by laparoscopy, most cases have been limited to left-sided IHD stones. The aim of this study was to evaluate the therapeutic feasibility and effectiveness of a laparoscopic approach for right-sided IHD stones compared with the open approach for this disease. Methods This study included 34 consecutive patients who underwent laparoscopic (n?=?17) and open (n?=?17) treatment for right-sided IHD stones from March 2005 to December 2011. Clinical data including the operative time, intraoperative blood loss, postoperative hospital length of stay, postoperative complications, stone clearance, and recurrence rate were retrospectively analyzed and compared between the two groups. Results Of the 17 patients who underwent laparoscopic treatment, three were treated using laparoscopic intrahepatic duct exploration alone and 14 patients were treated using laparoscopic liver resection. The operative time in the laparoscopic group was longer than that in the open group (432?±?158 vs. 335?±?85?min, p?=?0.03). The laparoscopic group showed a lower postoperative complication rate than the open group (29 vs. 64?%, p?=?0.039). There were no significant differences in intraoperative blood loss (988?±?929 vs. 879?±?942?ml, p?=?0.737) or postoperative length of hospital stay (16?±?22 vs. 12?±?14?days, p?=?0.221). Conclusions This study demonstrated that laparoscopic treatment could be an effective and safe therapeutic modality in selected patients with right-sided IHD stones.