关键词: 肝内外胆管结石, 左半肝切除, 腹腔镜手术, 开腹手术, 左肝蒂阻断, 治疗

Abstract: Objective The aim of this study was to compare the clinical efficacy of complete laparoscopic left hemihepatectomy and traditional open laparotomy with left hepatic pedicle occlusion in treatment of patients with intrahepatic and extrahepatic bile duct stones. Methods A total of 78 patients with intrahepatic and extrahepatic bile duct stones were admitted to our hospital between January 2016 and December 2021, and out of them, 45 patients underwent laparoscopic left hemihepatectomy with left hepatic pedicle occlusion and 33 patients received open laparotomy with left hepatic pedicle occlusion. Results In patients receiving laparoscopic operation, the operation time was (4.6±0.9) h, significantly longer than [(3.6±0.6) h, P<0.05], the postoperative exhaust time and hospitalization time were (22.8±8.4) h and (9.4±2.5) d, significantly shorter than [(44.6±10.5) h and (12.3±3.1) d, P<0.05] in patients with open operation, while the intraoperative blood loss in the two groups was not significantly different [(190.6±45.7)ml vs. (212.5±50.4)ml, P＞0.05]; one week after operation, serum ALT, AST and GGT levels in patients receiving laparoscopic operation were (33.5±6.8)U/L, (43.1±7.4)U/L and (56.0±8.4)U/L, much lower than [(39.7±5.2)U/L, (50.8±8.2)U/L and (64.2±8.8)U/L, respectively, P<0.05] in patients receiving open operation; the incidence of postoperative complications, such as incision or abdominal infection, biliary leakage, ascites and pneumonia between the two groups was not statistically significantly different (4.4% vs. 12.1%, P>0.05). Conclusion The application of complete laparoscopic left hemihepatectomy with left hepatic pedicle occlusion is a safe and feasible operation in the treatment of patients with intrahepatic and extrahepatic bile duct stones.

Key words: Cholelithiasis, Left hemihepatectomy, Laparoscopy, Laparotomy, Left hepatic pedicle occlusion, Therapy