Abstract: Objective The aim of this study was to compare the advantages of gallbladder posterior triangle approach (GPTA) to triangle approach (TA) during laparoscopic cholecystectomy (LC) in treatment of patients with gallbladder stones and chronic cholecystitis (CC). Methods 62 patients with gallbladder stones and CC were admitted to our hospital between January 2018 and December 2022, and were randomly divided into observation and control group, with 31 cases in each group. The patients in the observation received LC through GPTA, and those through TA. Serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) levels were detected by ELISA, and the percentages of peripheral blood lymphocyte subsets were detected by flow cytometry. Results The operation time, intraoperative blood loss, recovery time of gastrointestinal functions and post-operational hospitalization stay in the observation group were(27.5±2.4)min, (27.8±4.3)mL, (20.4±3.2)h and (3.9±0.9)d, all significantly less or shorter than [(32.9±3.8)min, (40.6±6.5)mL, (27.9±4.5)h and (6.2±1.5)d, respectively, P＜0.05] in the control; at day three post-operationally, serum CRP, TNF-α and IL-8 levels in the observation group were (32.7±2.5)mg/L,(16.4±2.6)ng/L and (11.2±2.5)ng/L, all much lower than [(44.5±3.9)mg/L, (20.6±2.9)ng/L and (16.8±2.7)ng/L, respectively, P＜0.05] in the control; the percentages of peripheral blood CD4⁺ and CD8⁺ cells as well as the CD4⁺/CD8⁺ cell ratio in the observation were (50.6±2.3)%,(25.6±3.7)% and (1.9±0.6), not significantly different compared to [(51.2±2.7)%, (26.1±3.4)% and (1.9±0.8)] in the control group (P>0.05); post-operationally, the incidences of complications, such as bile leak and/or bile duct injury, in the observation group was 9.7%, much lower than 32.3%(P＜0.05) in the control. Conclusion The GPTA during LC in treatment of patients with cholecystolithiasis and CC is superior to TA, which might be related to relatively easy manipulation and less complications.

Key words: Cholecystolithiasis, Chronic cholecystitis, Laparoscopic cholecystectomy, Through gallbladder posterior triangle approach, Through gallbladder triangle approach, Reactive response, Therapy