PDF(Pubmed)
Abstract：
The increased incidence of gallstones can be linked to previous gastrectomy (PG). However, the success rate of endoscopic retrograde cholangiopan-creatography after gastrectomy has significantly reduced. In such cases, laparoscopic transcystic common bile duct exploration (LTCBDE) may be an alternative. In this study, LTCBDE was evaluated for its safety and feasibility in patients with PG. We retrospectively evaluated 300 patients who underwent LTCBDE between January 2015 and June 2023. The subjects were divided into 2 groups according to their PG status: PG group and No-PG group. The perioperative data from the 2 groups were compared. The operation time in the PG group was longer than that in the No-PG group (184.69 ± 20.28 minutes vs 152.19 ± 26.37 minutes, P < .01). There was no significant difference in intraoperative blood loss (61.19 ± 41.65 mL vs 50.83 ± 30.47 mL, P = .087), postoperative hospital stay (6.36 ± 1.94 days vs 5.94 ± 1.36 days, P = .125), total complication rate (18.6 % vs 14.1 %, P = .382), stone clearance rate (93.2 % vs 96.3 %, P = .303), stone recurrence rate (3.4 % vs 1.7 %, P = .395), and conversion rate (6.8 % vs 7.0 %, P = .941) between the 2 groups. No deaths occurred in either groups. A history of gastrectomy may not affect the feasibility and safety of LTCBDE, because its perioperative results are comparable to those of patients with a history of No-gastrectomy.
摘要：
胆结石发病率的增加可能与以前的胃切除术（PG）有关。然而,胃切除术后内镜逆行胰胆管造影术的成功率明显降低。在这种情况下,腹腔镜经胆囊胆总管探查术（LTCBDE）可能是一种替代方法。在这项研究中,评估了LTCBDE在PG患者中的安全性和可行性。我们回顾性评估了2015年1月至2023年6月期间300例接受LTCBDE治疗的患者。根据PG状态分为2组：PG组和No-PG组。比较2组围手术期资料。PG组手术时间长于No-PG组(184.69±20.28分钟vs152.19±26.37分钟,P<.01)。术中出血量差异无统计学意义(61.19±41.65mLvs50.83±30.47mL,P=.087），术后住院时间（6.36±1.94天vs5.94±1.36天，P=.125），总并发症发生率（18.6%vs14.1%，P=.382)，结石清除率（93.2%vs96.3%，P=.303)，结石复发率（3.4%vs1.7%，P=.395)，和转化率(6.8%对7.0%，P=0.941）两组之间。两组均无死亡病例。胃切除术史可能不会影响LTCBDE的可行性和安全性，因为其围手术期结果与有非胃切除术史的患者相当。
