Effects of laparoscopic retrograde cholecystectomy versus partial cholecystectomy in treatment of complex bile duct diseases: a comparative analysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo compare the clinical effect between laparoscopic retrograde cholecystectomy and partial cholecystectomy in the treatment of patients with complex bile duct diseases. MethodsThe clinical data of 83 patients with bile duct diseases who were diagnosed and treated in Guangyuan Mental Health Center from June 2013 to March 2015 were collected. Among these patients, 40 underwent laparoscopic retrograde cholecystectomy (group A), and 43 underwent partial cholecystectomy (group B). The surgical procedure and postoperative recovery were compared between the two groups. The independent samples t-test was applied for comparison of continuous data between groups, and the paired t-test was applied for comparison of continuous data within each group before and after treatment; the chi-square test was applied for comparison of categorical data between groups. ResultsCompared with group A, group B had a significantly shorter time of operation, a significantly less blood loss, a significantly lower volume of intraoperative fluid infusion, and a significantly lower volume of peritoneal drainage (t=9.245, 2.394, 2.529, and 3.603, all P＜0.05). The rate of conversion to laparotomy, time to functional recovery of the gastrointestinal tract, and length of hospital stay showed no significant differences between the two groups (all P＞0.05). The body temperature and C-reactive protein on days 1-3 after surgery showed no significant differences between the two groups (all P＞005), while in both groups, the body temperature and C-reactive protein were significantly lower on the 2nd and 3rd days than on the 1st day. (t=3.184, 3.402, 3.151, 3.390, 3.497, 5.184, 3.916, and 6.024, all P＜0.05). Group B had a significantly lower incidence of postoperative complications than group A (2.33% vs 20.00%, χ2=6.696, P=0.010). ConclusionCompared with laparoscopic retrograde cholecystectomy, partial cholecystectomy can shorten the time of operation and reduce intraoperative bleeding and postoperative complications, and holds promise for clinical application.