Analysis Of The Effectiveness And Safety Of Laparoscopic-assisted Endoscopic Gallbladder-preserving Surgery

Background and aims:Polypoid lesion of gallbladder(PLG)is a common benign gallbladder disease,and its incidence has been increasing in recent years.According to studies,PLG is present in 10% to 20% of adults worldwide.Laparoscopic cholecystectomy(LC)is currently the main method for the treatment of PLG,but it still has many short-term and long-term complications,such as duodenogastric reflux,diarrhea,bile duct and vascular injury and choledocholithiasis.Because of the increasing demand of patients with PLG to preserve gallbladder function,it is necessary for physicians to seek new gallbladder-preserving methods for the treatment of PLG.In this case,laparoscopic-assisted endoscopic gallbladder-preserving surgery(La-EGPS)becomes a more minimally invasive and safer treatment option for these patients.By comparing the effectiveness and safety of LC and La-EGPS in the treatment of PLG,this study provides an effective and safe treatment reference for patients who have the desire for gallbladder-preserving treatment.Methods:This study analyzed the clinical data of a total of 37 patients who underwent La-EGPS and LC for polypoid lesion of gallbladder at the NO.1Central Hospital of Baoding from September 2021 to March 2023,including the number of cases,gender and age of patients with polypoid lesion of gallbladder treated by surgical modalities in both groups,observation and recording of the diameter of the excised lesions and endoscopic manifestations,collection and recording of lesion Postoperative pathological findings were collected and recorded,as well as intraoperative and postoperative conditions,including perioperative indicators for both groups,including operative time(min),intraoperative bleeding(ml),anal exhaust time(h),the leaving bed time(h),length of hospital stay(d),postoperative complications including dyspepsia,abdominal pain and diarrhoea,biliary leakage,biliary bleeding,incisional infection,hepatobiliary duct damage and total complications,postoperative pain scores of patients,as well as the follow-up of patients who had undergone the procedure at 3/6/12 months.The aim was to investigate the effectiveness and safety of La-EGPS and to provide a reference for the choice of clinical treatment modalities.Results:1.As of the follow-up date,a total of 18 patients were included in the LaEGPS group and 19 patients in the LC group,both groups completed the surgery successfully.Comparison of perioperative indicators between the La-EGPS group and the LC group showed that operative time(min)[(50.7±14.3)vs.(63.5±13.9)],intraoperative bleeding(ml)[(10.6±2.8)vs.(15.5±3.0)],anal exhaust time(h)[(19.3±3.4)vs.26.4±3.5)],length of hospital stay(d)[(6.6±1.1)vs(7.5±1.2)],and the leaving bed time(h)[13.5(9.0,19.0)vs 7.8(6.0,16.6)],all with statistically significant differences(P<0.05).2.In terms of postoperative complications: there was no difference in the La-EGPS group compared to the LC group in terms of postoperative dyspepsia,abdominal pain and diarrhoea,biliary blood accumulation,incisional infection,bile leak and hepatobiliary duct injury(P>0.05).In terms of postoperative pain scores and total complications,the study showed that the La-EGPS group performed better(P< 0.05).Conclusions:In this study,compared with LC,La-EGPS had a slight advantage in terms of operation time,intraoperative bleeding,anal exhaust time,length of hospital stay,the leaving bed time,postoperative pain score and total complications.It is suggested that La-EGPS can safely and minimally remove PLG and improve the quality of life of patients.This procedure provides a new option for patients with PLG requiring gallbladder preservation.