LAPAROSCOPIC CHOLECYSTOLITHOTOMY VERSUS LAPAROSCOPIC (SINGLE-PORT AND FOUR-PORT) CHOLECYSTECTOMY
The purpose of the study is a comparative analysis of laparoscopic cholecystolithotomy and (single-port and four-port) cholecystectomy in patients with cholecystolithiasis with isolated gallstones. Material and methods. 136 patients with cholecystolithiasis were involved in a one-center open prospective study, aged between 22 and 78 years, mean age was 48.9 ± 12.6 years, among them 79.41 % were women. Depending on the method of treatment, the patients were divided into three groups. The first group consisted of 53 patients who underwent laparoscopic four-port cholecystectomy (4-port laparoscopic cholecystectomy - 4PLC), the second - 50 patients who underwent single-incision laparoscopic cholecystectomy (SILC), the third group - 33 patients who underwent laparoscopic cholecystolithotomy (LCLT). Groups of patients were comparable in age. The operating time, the terms of activation after surgery, the hospital length of stay, the duration of hyperthermia, intraoperative and postoperative complications presence were analyzed. Results. The mean duration of laparoscopic four-port cholecystectomy was 42.83 ± 16.97 minutes, that was significantly greater than the mean duration of SILC (36.60 ± 14.37 minutes), (P = 0.039), but shorter than the mean duration of laparoscopic cholecystolythotomy (61.06 ± 13.27 minutes), (P = 0.001). The shortest hospital length of stay was in LCLT group. The hyperthermia duration after surgical interventions did not depend on the type of operation (P > 0.05) and did not exceed one day for all types of operations. In 42.6 % (58/126) of the total number of operated patients temperature rise was not observed at all, among them 23 patients in the 4PLC group, 21 patients in the SILC group and 14 patients in the LCLT group. Conclusions. Laparoscopic cholecystolithotomy allows gall bladder-preserving and postcholecystectomy syndrome development preventing in patients with cholecystolithiasis, reducing the number of postoperative complications and the hospital length of stay. Reduction of recurrent stones formation in the bile ducts after operations on the gall bladder is associated with organ-preserving interventions, namely cholecystolythotomy.