A Retrospective Study on the Three-Port Technique of Laparoscopic Common Bile Duct Exploration for the Management of Cholelithiasis and Choledocholithiasis

Chunlong Zhao; Zipeng Xu; Weidong Hu; Chen Ge; Zhengwei Zhang; Zhengxing Dai; Shuo Zhang; Neng Tang; Weiguo Wang; Jiayu Gu; Chaobo Chen; Songbing He

doi:10.2147/IJGM.S415752

A Retrospective Study on the Three-Port Technique of Laparoscopic Common Bile Duct Exploration for the Management of Cholelithiasis and Choledocholithiasis

Int J Gen Med. 2023 Aug 11:16:3435-3445. doi: 10.2147/IJGM.S415752. eCollection 2023.

Authors

Chunlong Zhao^#^{1

2}, Zipeng Xu^#¹, Weidong Hu^#¹, Chen Ge¹, Zhengwei Zhang¹, Zhengxing Dai³, Shuo Zhang⁴, Neng Tang⁴, Weiguo Wang³, Jiayu Gu³, Chaobo Chen^{1

4

5}, Songbing He²

Affiliations

¹ Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, People's Republic of China.
² Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
³ Department of Interventional and Vascular Surgery, Xishan People's Hospital of Wuxi City, Wuxi, People's Republic of China.
⁴ Department of Hepatic-Biliary-Pancreatic Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People's Republic of China.
⁵ Department of Immunology, Ophthalmology & ORL, Complutense University School of Medicine, Madrid, Spain.

^# Contributed equally.

Abstract

Background: Laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) is convenient in treating cholelithiasis and choledocholithiasis due to its advantage of accelerated recovery. This retrospective study aimed to summarize the experience of cholelithiasis and choledocholithiasis treatment via three-port approach of LCBDE in Eastern China.

Methods: Patients diagnosed with cholelithiasis and choledocholithiasis between July 2019 and October 2021 were included. Patients who received LC+LCBDE+primary suturing of the common bile duct (CBD) via a three-port approach were assigned to the LCBDE-P group, and those who received LC+LCBDE+T-tube drainage of CBD comprised the LCBDE-T group. The measurement data were compared between the two groups. P-values <0.05 indicated statistical significance.

Results: A total of 88 patients were divided into two groups: LCBDE-P (n=50) and LCBDE-T (n=38). Multiple logistic regression analysis showed that LCBDE-P is associated with a shorter length of stay (OR=0.115, 95% CI: 0.040-0.329, P<0.001) and lower hospitalization costs (OR=0.120, 95% CI: 0.041-0.357, P<0.001). No significant differences between the two groups were detected in the operation time, intraoperative hemorrhage, clearance rate of CBD stones, postoperative liver function, and postoperative complications (P>0.05).

Conclusion: The three-port approach of LCBDE is a safe and feasible strategy for managing cholelithiasis and choledocholithiasis. Compared to LCBDE-T, LCBDE-P reduces the length of hospital stay and medical costs during hospitalization.

Keywords: T-tube drainage; choledocholithiasis; cholelithiasis; laparoscopic cholecystectomy; laparoscopic common bile duct exploration; primary suture.

Grants and funding

This study was supported by a research project of Wuxi Municipal Health Commission (Project, No. M202160), Project of National Science Foundation of Jiangsu Province of China (BK20191172), Project of Gusu Medical Key Talent of Suzhou City of China (GSWS2020005), and Project of New Pharmaceutics and Medical Apparatuses of Suzhou City of China (SLJ2021007).