3D laparoscopic common bile duct exploration versus 2D in choledocholithiasis patients: a propensity score analysis

Xiaobo Bo; Jie Wang; Lingxi Nan; Yanlei Xin; Zhihui Gao; Changcheng Wang; Min Li; Sheng Shen; Han Liu; Xiaoling Ni; Tao Suo; Pinxiang Lu; Dexiang Zhang; Yueqi Wang; Houbao Liu

doi:10.1007/s00464-020-07453-3

3D laparoscopic common bile duct exploration versus 2D in choledocholithiasis patients: a propensity score analysis

Surg Endosc. 2021 Feb;35(2):819-825. doi: 10.1007/s00464-020-07453-3. Epub 2020 Mar 20.

Authors

Xiaobo Bo^#^{1

2}, Jie Wang^#^{1

2}, Lingxi Nan^#^{1

2}, Yanlei Xin^{1

2}, Zhihui Gao^{1

2}, Changcheng Wang¹, Min Li^{1

2}, Sheng Shen^{1

2}, Han Liu^{1

2}, Xiaoling Ni^{1

2}, Tao Suo^{1

2}, Pinxiang Lu¹, Dexiang Zhang³, Yueqi Wang^{4

5}, Houbao Liu^{6

7

8}

Affiliations

¹ Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.
² Biliary Tract Diseases Institute, Fudan University, 180 Fenglin Rd., Shanghai, 200032, China.
³ General Surgery Department, Zhongshan-Xuhui Hospital Affiliated to Fudan University, 966 Middle Huaihai Rd., Shanghai, 200031, China.
⁴ Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China. yueqiwang@fudan.edu.cn.
⁵ Biliary Tract Diseases Institute, Fudan University, 180 Fenglin Rd., Shanghai, 200032, China. yueqiwang@fudan.edu.cn.
⁶ Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China. houbaoliu@aliyun.com.
⁷ General Surgery Department, Zhongshan-Xuhui Hospital Affiliated to Fudan University, 966 Middle Huaihai Rd., Shanghai, 200031, China. houbaoliu@aliyun.com.
⁸ Biliary Tract Diseases Institute, Fudan University, 180 Fenglin Rd., Shanghai, 200032, China. houbaoliu@aliyun.com.

^# Contributed equally.

PMID: 32198551
DOI: 10.1007/s00464-020-07453-3

Abstract

Background: This study was designed to investigate whether 3D laparoscopic common bile duct (LCBDE) could improve surgical outcomes in choledocholithiasis patients compared with 2D LCBDE.

Method: Propensity score-matched analysis was performed to balance the bias in baseline characteristic between two groups.

Results: 213 patients underwent 3D LCBDE and 212 patients receiving 2D LCBDE were enrolled in this study. The operation time and blood loss in 3D group were significantly less than that in 2D group. After propensity score matching, a total of 114 paired cases were selected from the two groups. The operation time and blood loss in 3D group remain significantly lower than in 2D group. In the end, the subgroup analysis based on abdominal adhesion level was performed and it was observed that for patients with adhesion level 1 and level 2, 3D surgery could obviously decrease the operation time and intraoperative blood loss.

Conclusions: 3D LCBDE would significantly reduce operation time, blood loss, and conversion rate to laparotomy in choledocholithiasis patients versus 2D LCBDE. For patients with abdominal adhesions level 1 and level 2, 3D LCBDE could provide better surgical outcomes than 2D LCBDE.

Keywords: 3D; Abdominal adhesions; Choledocholithiasis; Laparoscopy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Choledocholithiasis / diagnostic imaging*
Common Bile Duct / diagnostic imaging*
Female
Humans
Imaging, Three-Dimensional / methods*
Male
Middle Aged
Propensity Score