Abstract
Objective To assess the clinical effectiveness of laparoscopic fiberoptic choledochoscopy versus conventional open surgery for gallbladder stones complicated with common bile duct stones. Methods In this retrospective study, 110 patients with gallbladder stones complicated with common bile duct stones treated in our institution between May 2018 and April 2020 were recruited and assigned to receive either open surgery (conventional group) or laparoscopic fiberoptic choledochoscopy (experimental group). Outcome measures included intraoperative indices, postoperative indices, postoperative complications, and changes in postoperative blood indices. Results Laparoscopic fiberoptic choledochoscopy was associated with less intraoperative bleeding volume and a shorter surgical incision length versus open surgery (P < 0.05). All eligible patients showed similar operative time (P > 0.05). Laparoscopic fiberoptic choledochoscopy resulted in shorter postoperative exhaust time and mean length of stay and a higher mean hospitalization cost versus open surgery (P < 0.05). There was no significant difference in the number of patients with intensive care units (ICU) monitoring or primary suture of the common bile duct between the two groups (P > 0.05). The eligible patients after laparoscopic fiberoptic choledochoscopy experienced fewer complications versus those after open surgery (P < 0.05). Laparoscopic fiberoptic choledochoscopy had a milder impact on postoperative albumin decrease versus open surgery (P < 0.05). No significant difference was found in the postoperative leukocyte changes and total bilirubin decrease between the two groups (P > 0.05). Conclusion Laparoscopic fiberoptic choledochoscopy has better perioperative indices outcomes, lower incidence of postoperative complications, smaller postoperative albumin changes, and superior overall performance versus conventional open surgery for gallbladder stones complicated with common bile duct stones.
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