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3D laparoscopic common bile duct exploration versus 2D in choledocholithiasis patients: a propensity score analysis
Surgical Endoscopy ( IF 3.1 ) Pub Date : 2020-03-20 , DOI: 10.1007/s00464-020-07453-3
Xiaobo Bo 1, 2 , Jie Wang 1, 2 , Lingxi Nan 1, 2 , Yanlei Xin 1, 2 , Zhihui Gao 1, 2 , Changcheng Wang 1 , Min Li 1, 2 , Sheng Shen 1, 2 , Han Liu 1, 2 , Xiaoling Ni 1, 2 , Tao Suo 1, 2 , Pinxiang Lu 1 , Dexiang Zhang 3 , Yueqi Wang 1, 2 , Houbao Liu 1, 2, 3
Affiliation  

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.



中文翻译:

胆总管结石症患者的3D腹腔镜胆总管探查与2D对比:倾向评分分析

摘要

背景

本研究旨在调查3D腹腔镜胆总管(LCBDE)与2D LCBDE相比是否可以改善胆总管结石患者的手术效果。

方法

进行倾向得分匹配分析以平衡两组之间基线特征的偏差。

结果

213例患者接受了3D LCBDE,212例患者接受了2D LCBDE。3D组的手术时间和失血量明显少于2D组。倾向得分匹配后,从两组中总共选择了114个配对病例。3D组的手术时间和失血量明显低于2D组。最后,进行了基于腹腔粘连水平的亚组分析,发现对于粘连水平为1和2的患者,3D手术可以明显减少手术时间和术中失血量。

结论

与2D LCBDE相比,3D LCBDE可以显着减少胆总管结石症患者的手术时间,失血量和开腹手术的转化率。对于腹部粘连为1级和2级的患者,3D LCBDE的手术效果比2D LCBDE更好。

更新日期:2020-03-21
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