Clinical effect of laparoscopic left lateral hepatectomy in treatment of intrahepatic bile duct stones / 临床肝胆病杂志

ABSTRACT

Objective To investigate the surgical method,safety,and clinical effect of laparoscopic left lateral hepatectomy in the treatment of intrahepatic bile duct stones.Methods A total of 30 patients with intrahepatic bile duct stones who were admitted to our hospital from January 2015 to December 2016 were enrolled,and according to the surgical procedure,these patients were divided into conventional group (15 patients) and laparoscopic group (15 patients).The patients in the conventional group were treated with open left lateral hepatectomy,and those in the laparoscopic group were treated with minimally invasive laparoscopic left lateral hepatectomy.Surgical indices were observed,and postoperative complications and liver function parameters were compared between the two groups.The t-test was used for comparison of normally distributed continuous data,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data.The chi-square test was used for comparison of categorical data.Results The laparoscopic group had significant reductions in the time to passage of gas by anus (1.02 ± 0.51 d vs 1.98 ± 0.36 d,t =5.956,P ＜0.001) and length of postoperative hospital stay (8.83 ±0.81 d vs 11.83 ± 0.42 d,t =5.830,P ＜ 0.001) compared with the conventional group.Compared with the conventional group,the laparoscopic group had a significantly lower alanine aminotransferase level (125.8 ± 91.9 U/L vs 214.1 ± 99.6 U/L,t =2.52,P =0.02) and a significantly higher serum albumin level (33.2 ± 3.7 g/L vs 28.9 ± 4.3 g/L,t =2.94,P =0.01) at 5 days after surgery.Conclusion Compared with conventional open surgery,laparoscopic left lateral hepatectomy has the features of litde trauma,rapid postoperative recovery,and little influence on liver function in the treatment of intrahepatic bile duct stones and has a marked clinical effect.Therefore,it holds promise for clinical application.