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| Clinical effect of laparoscopic left lateral hepatic lobectomy in the treatment of patients with intrahepatic bile duct stones |
| WANG Liang JIN Xing |
| Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Fujian Medical University |
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Abstract Objective To investigate the clinical effect of laparoscopic left lateral hepatic lobectomy in the treatment of patients with intrahepatic bile duct stones (IHS). Methods A total of 82 patients with left IHS treated in the First Affiliated Hospital of Fujian Medical University from October 2017 to September 2020 were selected and divided into two groups according to the random number table method, with 41 cases in each group. The observation group was treated with laparoscopic left lateral hepatic lobectomy. The control group was treated with open left lateral hepatic lobectomy.The perioperative indicators, stress response, stone clearance rate and complications were compared between the two groups. Results The intraoperative blood loss in the observation group was (173.69±31.25) ml, less than that of the control group of (214.38±35.20) ml, the incision length, the operation time and the length of stay in the observation group were (5.01±0.85) cm, (126.46±30.08) min and (7.83±2.15) d, shorter than those of the control group of (10.94±2.13) cm, (148.97±28.41) min and (11.58±2.91) d, the postoperative cortisol (Cor), epinephrine (E) and blood glucose(Glu) in the observation group were (254.38±26.79) nmol/L, (138.44±18.24) ng/ml and (5.74±0.60) mmol/L, lower than those of the control group of (304.19±28.53) nmol/L, (151.97±23.07) ng/ml and (6.89±0.76) mmol/L, with statistical significances (P＜0.05). There were no statistical differences between the two groups in the rate of stone clearance and the overall incidence of complications (P＞0.05). Conclusion The laparoscopic left lateral hepatic lobectomy for IHS patients is mild traumatic and has a high stone clearance rate, which is beneficial to reduce the surgical stress response and promote the patients' early recovery. It is a safe and effective procedure for the treatment of IHS.
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