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Erschienen in: Surgical Endoscopy 2/2021

20.03.2020

3D laparoscopic common bile duct exploration versus 2D in choledocholithiasis patients: a propensity score analysis

verfasst von: Xiaobo Bo, Jie Wang, Lingxi Nan, Yanlei Xin, Zhihui Gao, Changcheng Wang, Min Li, Sheng Shen, Han Liu, Xiaoling Ni, Tao Suo, Pinxiang Lu, Dexiang Zhang, Yueqi Wang, Houbao Liu

Erschienen in: Surgical Endoscopy | Ausgabe 2/2021

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Abstract

Background

This study was designed to investigate whether 3D laparoscopic common bile duct (LCBDE) could improve surgical outcomes in choledocholithiasis patients compared with 2D LCBDE.

Method

Propensity score-matched analysis was performed to balance the bias in baseline characteristic between two groups.

Results

213 patients underwent 3D LCBDE and 212 patients receiving 2D LCBDE were enrolled in this study. The operation time and blood loss in 3D group were significantly less than that in 2D group. After propensity score matching, a total of 114 paired cases were selected from the two groups. The operation time and blood loss in 3D group remain significantly lower than in 2D group. In the end, the subgroup analysis based on abdominal adhesion level was performed and it was observed that for patients with adhesion level 1 and level 2, 3D surgery could obviously decrease the operation time and intraoperative blood loss.

Conclusions

3D LCBDE would significantly reduce operation time, blood loss, and conversion rate to laparotomy in choledocholithiasis patients versus 2D LCBDE. For patients with abdominal adhesions level 1 and level 2, 3D LCBDE could provide better surgical outcomes than 2D LCBDE.
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Literatur
1.
Zurück zum Zitat Chan DS, Jain PA, Khalifa A et al (2014) Laparoscopic common bile duct exploration. Br J Surg 101:1448–1452CrossRef Chan DS, Jain PA, Khalifa A et al (2014) Laparoscopic common bile duct exploration. Br J Surg 101:1448–1452CrossRef
2.
Zurück zum Zitat Tan J, Tan Y, Chen F et al (2015) Endoscopic or laparoscopic approach for hepatolithiasis in the era of endoscopy in China. Surg Endosc 29:154–162CrossRef Tan J, Tan Y, Chen F et al (2015) Endoscopic or laparoscopic approach for hepatolithiasis in the era of endoscopy in China. Surg Endosc 29:154–162CrossRef
3.
Zurück zum Zitat Baucom RB, Feurer ID, Shelton JS et al (2016) Surgeons, ERCP, and laparoscopic common bile duct exploration: do we need a standard approach for common bile duct stones? Surg Endosc 30:414–423CrossRef Baucom RB, Feurer ID, Shelton JS et al (2016) Surgeons, ERCP, and laparoscopic common bile duct exploration: do we need a standard approach for common bile duct stones? Surg Endosc 30:414–423CrossRef
4.
Zurück zum Zitat Tzovaras G, Baloyiannis I, Zachari E et al (2012) Laparoendoscopic rendezvous versus preoperative ERCP and laparoscopic cholecystectomy for the management of cholecysto-choledocholithiasis: interim analysis of a controlled randomized trial. Ann Surg 255:435–439CrossRef Tzovaras G, Baloyiannis I, Zachari E et al (2012) Laparoendoscopic rendezvous versus preoperative ERCP and laparoscopic cholecystectomy for the management of cholecysto-choledocholithiasis: interim analysis of a controlled randomized trial. Ann Surg 255:435–439CrossRef
5.
Zurück zum Zitat Zheng C, Huang Y, Xie E et al (2017) Laparoscopic common bile duct exploration: a safe and definitive treatment for elderly patients. Surg Endosc 31:2541–2547CrossRef Zheng C, Huang Y, Xie E et al (2017) Laparoscopic common bile duct exploration: a safe and definitive treatment for elderly patients. Surg Endosc 31:2541–2547CrossRef
6.
Zurück zum Zitat Velayutham V, Fuks D, Nomi T et al (2016) 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study. Surg Endosc 30:147–153CrossRef Velayutham V, Fuks D, Nomi T et al (2016) 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study. Surg Endosc 30:147–153CrossRef
7.
Zurück zum Zitat Wagner OJ, Hagen M, Kurmann A et al (2012) Three-dimensional vision enhances task performance independently of the surgical method. Surg Endosc 26:2961–2968CrossRef Wagner OJ, Hagen M, Kurmann A et al (2012) Three-dimensional vision enhances task performance independently of the surgical method. Surg Endosc 26:2961–2968CrossRef
8.
Zurück zum Zitat Bilgen K, Ustun M, Karakahya M et al (2013) Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 23:180–183CrossRef Bilgen K, Ustun M, Karakahya M et al (2013) Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 23:180–183CrossRef
9.
Zurück zum Zitat Cologne KG, Zehetner J, Liwanag L et al (2015) Three-dimensional laparoscopy: does improved visualization decrease the learning curve among trainees in advanced procedures? Surg Laparosc Endosc Percutan Tech 25:321–323CrossRef Cologne KG, Zehetner J, Liwanag L et al (2015) Three-dimensional laparoscopy: does improved visualization decrease the learning curve among trainees in advanced procedures? Surg Laparosc Endosc Percutan Tech 25:321–323CrossRef
10.
Zurück zum Zitat Sakata S, Grove PM, Stevenson AR (2016) Effect of 3-dimensional vision on surgeons using the da Vinci robot for laparoscopy: more than meets the eye. JAMA Surg 151:793–794CrossRef Sakata S, Grove PM, Stevenson AR (2016) Effect of 3-dimensional vision on surgeons using the da Vinci robot for laparoscopy: more than meets the eye. JAMA Surg 151:793–794CrossRef
11.
Zurück zum Zitat Dowson HM, Bong JJ, Lovell DP et al (2008) Reduced adhesion formation following laparoscopic versus open colorectal surgery. Br J Surg 95:909–914CrossRef Dowson HM, Bong JJ, Lovell DP et al (2008) Reduced adhesion formation following laparoscopic versus open colorectal surgery. Br J Surg 95:909–914CrossRef
12.
Zurück zum Zitat Pan L, Chen M, Ji L et al (2018) The Safety and efficacy of laparoscopic common bile duct exploration combined with cholecystectomy for the management of cholecysto-choledocholithiasis: an up-to-date meta-analysis. Ann Surg 268(2):247–253CrossRef Pan L, Chen M, Ji L et al (2018) The Safety and efficacy of laparoscopic common bile duct exploration combined with cholecystectomy for the management of cholecysto-choledocholithiasis: an up-to-date meta-analysis. Ann Surg 268(2):247–253CrossRef
13.
Zurück zum Zitat Zhou Y, Wu XD, Fan RG et al (2014) Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg 12:645–648CrossRef Zhou Y, Wu XD, Fan RG et al (2014) Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg 12:645–648CrossRef
14.
Zurück zum Zitat Vidagany NE, Del Domingo CD, Tomas NP et al (2016) Eleven years of primary closure of common bile duct after choledochotomy for choledocholithiasis. Surg Endosc 30:1975–1982CrossRef Vidagany NE, Del Domingo CD, Tomas NP et al (2016) Eleven years of primary closure of common bile duct after choledochotomy for choledocholithiasis. Surg Endosc 30:1975–1982CrossRef
15.
Zurück zum Zitat Feng X, Morandi A, Boehne M et al (2015) 3-Dimensional (3D) laparoscopy improves operating time in small spaces without impact on hemodynamics and psychomental stress parameters of the surgeon. Surg Endosc 29:1231–1239CrossRef Feng X, Morandi A, Boehne M et al (2015) 3-Dimensional (3D) laparoscopy improves operating time in small spaces without impact on hemodynamics and psychomental stress parameters of the surgeon. Surg Endosc 29:1231–1239CrossRef
16.
Zurück zum Zitat Kunert W, Storz P, Kirschniak A (2013) For 3D laparoscopy: a step toward advanced surgical navigation: how to get maximum benefit from 3D vision. Surg Endosc 27:696–699CrossRef Kunert W, Storz P, Kirschniak A (2013) For 3D laparoscopy: a step toward advanced surgical navigation: how to get maximum benefit from 3D vision. Surg Endosc 27:696–699CrossRef
17.
Zurück zum Zitat Mutter D, Dallemagne B, Bailey C et al (2009) 3D virtual reality and selective vascular control for laparoscopic left hepatic lobectomy. Surg Endosc 23:432–435CrossRef Mutter D, Dallemagne B, Bailey C et al (2009) 3D virtual reality and selective vascular control for laparoscopic left hepatic lobectomy. Surg Endosc 23:432–435CrossRef
18.
Zurück zum Zitat Sorensen SM, Savran MM, Konge L et al (2016) Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 30:11–23CrossRef Sorensen SM, Savran MM, Konge L et al (2016) Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 30:11–23CrossRef
19.
Zurück zum Zitat Wang Y, Bo X, Wang Y et al (2017) Laparoscopic surgery for choledocholithiasis concomitant with calculus of the left intrahepatic duct or abdominal adhesions. Surg Endosc 31:4780–4789CrossRef Wang Y, Bo X, Wang Y et al (2017) Laparoscopic surgery for choledocholithiasis concomitant with calculus of the left intrahepatic duct or abdominal adhesions. Surg Endosc 31:4780–4789CrossRef
20.
Zurück zum Zitat Zhu J, Sun G, Hong L et al (2018) Laparoscopic common bile duct exploration in patients with previous upper abdominal surgery. Surg Endosc 32(12):4893–4899CrossRef Zhu J, Sun G, Hong L et al (2018) Laparoscopic common bile duct exploration in patients with previous upper abdominal surgery. Surg Endosc 32(12):4893–4899CrossRef
21.
Zurück zum Zitat Srinivas GN (2006) Conversion rate for laparoscopic cholecystectomy after endoscopic retrograde cholangiography in the treatment of choledocholithiasis: does the time interval matter? Surg Endosc 20:1932CrossRef Srinivas GN (2006) Conversion rate for laparoscopic cholecystectomy after endoscopic retrograde cholangiography in the treatment of choledocholithiasis: does the time interval matter? Surg Endosc 20:1932CrossRef
22.
Zurück zum Zitat Cakir M, Kucukkartallar T, Tekin A et al (2015) Does endoscopic retrograde cholangiopancreatography have a negative effect on laparoscopic cholecystectomy? Ulus Cerrahi Derg 31:128–131PubMedPubMedCentral Cakir M, Kucukkartallar T, Tekin A et al (2015) Does endoscopic retrograde cholangiopancreatography have a negative effect on laparoscopic cholecystectomy? Ulus Cerrahi Derg 31:128–131PubMedPubMedCentral
23.
Zurück zum Zitat Schiphorst AH, Besselink MG, Boerma D et al (2008) Timing of cholecystectomy after endoscopic sphincterotomy for common bile duct stones. Surg Endosc 22:2046–2050CrossRef Schiphorst AH, Besselink MG, Boerma D et al (2008) Timing of cholecystectomy after endoscopic sphincterotomy for common bile duct stones. Surg Endosc 22:2046–2050CrossRef
24.
Zurück zum Zitat Behman R, Nathens AB, Byrne JP et al (2017) Laparoscopic surgery for adhesive small bowel obstruction is associated with a higher risk of bowel injury: a population-based analysis of 8584 patients. Ann Surg 266:489–498CrossRef Behman R, Nathens AB, Byrne JP et al (2017) Laparoscopic surgery for adhesive small bowel obstruction is associated with a higher risk of bowel injury: a population-based analysis of 8584 patients. Ann Surg 266:489–498CrossRef
Metadaten
Titel
3D laparoscopic common bile duct exploration versus 2D in choledocholithiasis patients: a propensity score analysis
verfasst von
Xiaobo Bo
Jie Wang
Lingxi Nan
Yanlei Xin
Zhihui Gao
Changcheng Wang
Min Li
Sheng Shen
Han Liu
Xiaoling Ni
Tao Suo
Pinxiang Lu
Dexiang Zhang
Yueqi Wang
Houbao Liu
Publikationsdatum
20.03.2020
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 2/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07453-3

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