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

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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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Acknowledgements

This study was supported by Grants from the National Natural Science Foundation of China (No. 81872352) and the Foundation of Shanghai Science and Technology Committee (16411952000) and JianFeng project of XuHui Provincial Commission of Health and Family Planning (SHXH201703) and the Shanghai Medical Discipline of Key Programs for General Surgery (2017ZZ02007) and Clinical Study of Zhongshan Hospital (2018ZSLC24).

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Author notes

  1. Xiaobo Bo, Jie Wang and Lingxi Nan contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China

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

  2. General Surgery Department, Zhongshan-Xuhui Hospital Affiliated to Fudan University, 966 Middle Huaihai Rd., Shanghai, 200031, China

    Dexiang Zhang & Houbao Liu

  3. Biliary Tract Diseases Institute, Fudan University, 180 Fenglin Rd., Shanghai, 200032, China

    Xiaobo Bo, Jie Wang, Lingxi Nan, Yanlei Xin, Zhihui Gao, Min Li, Sheng Shen, Han Liu, Xiaoling Ni, Tao Suo, Yueqi Wang & Houbao Liu

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  1. Xiaobo Bo
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  2. Jie Wang
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  4. Yanlei Xin
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  7. Min Li
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  9. Han Liu
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  10. Xiaoling Ni
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  11. Tao Suo
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  12. Pinxiang Lu
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  13. Dexiang Zhang
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  14. Yueqi Wang
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  15. Houbao Liu
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Corresponding authors

Correspondence to Yueqi Wang or Houbao Liu.

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Disclosures

Xiaobo Bo, Jie Wang, Yanlei Xin, Lingxi Nan, Zhihui Gao, Changcheng Wang, Min Li, Sheng Shen, Han Liu, Xiaoling Ni, Tao Suo, Dexiang Zhang, Yueqi Wang, Houbao Liu have no conflict of interest or financial ties to disclose.

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Bo, X., Wang, J., Nan, L. et al. 3D laparoscopic common bile duct exploration versus 2D in choledocholithiasis patients: a propensity score analysis. Surg Endosc 35, 819–825 (2021). https://doi.org/10.1007/s00464-020-07453-3

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  • DOI: https://doi.org/10.1007/s00464-020-07453-3

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