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Published on: April 11, 2025
Laparoscopic vs open surgery for complex hepatolithiasis: A retrospective comparative study
De-Xin Lin1,2, Xin-Bin Zhuo1,3, Gui-Jian Chang1,3
1Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde 352100, Fujian Province, China.
Background:
Laparoscopic surgery is increasingly used for complex hepatolithiasis; however, data on laparoscopic vs open surgery remain limited. This study was undertaken to test the hypothesis that laparoscopic surgery offers comparable safety and efficacy to open surgery, with added benefits in recovery outcomes.
Aim:
To compare clinical outcomes between laparoscopic and open approaches in complex hepatolithiasis.
Methods:
This retrospective cohort study was conducted at Ningde Municipal Hospital, a tertiary care center, and included 80 patients with complex hepatolithiasis treated between January 2020 and August 2024. Patients were non-randomly allocated to laparoscopic (n = 40) or open surgery (n = 40) groups based on the treatment period. Clinical, intraoperative, and postoperative data were analyzed using appropriate parametric or non-parametric tests; categorical data were analyzed using χ 2 or Fisher's exact test.
Results:
Laparoscopic surgery was associated with a longer median operative time (250.0 minutes vs 207.0 minutes, P = 0.003) but shorter postoperative hospital stay (9.0 days vs 14.0 days, P < 0.001) compared to open surgery. Wound infection rates were significantly less frequent in the laparoscopic group (5.0% vs 22.5%, P = 0.023). Stone clearance rates and overall complications were comparable. One case of perioperative mortality occurred in the open surgery cohort.
Conclusion:
Laparoscopic surgery is a feasible and safe alternative to open surgery for complex hepatolithiasis, offering faster recovery and reduced wound-related complications.
