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Retraction
Retracted: Therapeutic Effect of Laparoscopic Cholecystectomy on
Patients with Cholecystolithiasis Complicated with Chronic
Cholecystitis and Postoperative Quality of Life

Evidence-Based Complementary and Alternative Medicine

Received 20 June 2023; Accepted 20 June 2023; Published 21 June 2023

Copyright © 2023 Evidence-Based Complementary and Alternative Medicine. Tis is an open access article distributed under the
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References
(2) Discrepancies in the description of the research [1] J. Song, J. Chen, and C. Lin, “Terapeutic Efect of Laparoscopic
reported Cholecystectomy on Patients with Cholecystolithiasis Com-
plicated with Chronic Cholecystitis and Postoperative Quality
(3) Discrepancies between the availability of data and of Life,” Evidence-Based Complementary and Alternative
the research described Medicine, vol. 2022, Article ID 6813756, 6 pages, 2022.
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Hindawi
Evidence-Based Complementary and Alternative Medicine
Volume 2022, Article ID 6813756, 6 pages
https://doi.org/10.1155/2022/6813756

Research Article
Therapeutic Effect of Laparoscopic Cholecystectomy on
Patients with Cholecystolithiasis Complicated with Chronic
Cholecystitis and Postoperative Quality of Life

E D
Jie Song,1 Jie Chen,2 and Chunyan Lin
1
2
1

C T
Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
Department of Hepatobiliary Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China

Correspondence should be addressed to Chunyan Lin; linshaobengza4051@163.com

A
Received 22 April 2022; Revised 3 June 2022; Accepted 21 June 2022; Published 21 July 2022

Academic Editor: Xiaonan Xi

Copyright © 2022 Jie Song et al. )is is an open access article distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

R
Objective. To assess the treatment outcome and postoperative quality of life of patients with gallbladder stones and chronic
cholecystitis after open cholecystectomy and laparoscopic cholecystectomy. Methods. Between 2018 and 2020, 108 patients with
gallbladder stones and chronic cholecystitis treated in our hospital were assessed for eligibility and randomly recruited. )ey were
concurrently assigned (1 : 1) to receive either open cholecystectomy (control group) or laparoscopic cholecystectomy (study

T
group). Outcome measures include surgical indices, inflammatory response, postoperative complications, and quality of life of
patients. Results. Laparoscopic cholecystectomy was associated with a shorter duration of surgery, intraoperative bleeding, time to
first postoperative bowel movement, and postoperative hospital stay versus open cholecystectomy (P < 0.05). )e levels of
inflammatory factors of all eligible patients were comparable before cholecystectomy (P > 0.05). )e patients given laparoscopic
cholecystectomy showed lower levels of C-reactive protein (CRP), interleukin (IL)-6, and IL-8 versus those given open cho-

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lecystectomy (P < 0.05). Laparoscopic cholecystectomy resulted in a significantly lower incidence of complication (3.56%) versus
open cholecystectomy (24.07%) (P < 0.05). )e patients had significantly higher physical, psychological, and social function scores
after laparoscopic cholecystectomy versus open cholecystectomy (P < 0.05). Conclusion. Laparoscopic cholecystectomy provides
better surgical results, mitigates the inflammatory response, lowers the incidence of complications, and improves the quality of life
of patients versus open cholecystectomy, so it is worthy of application in clinical treatment.

1. Introduction

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Chronic cholecystitis is a chronic inflammatory lesion of the
digestive system, which is a chronic inflammation of the
gallbladder elicited by various causes such as recurrent acute
or subacute cholecystitis or long-standing gallstones [1]. )e
prevalence of chronic cholecystitis in adults is reported to be
0.78% to 3.91% in China, and the prevalence of gallbladder
stones is 2.3% to 6.5% [2]. )e prevalence of gallbladder
stones is higher in women than in men, and the peak in-
cidence is after the age of 50. As the standard of living of the
Chinese people continues to improve, the incidence of
chronic cholecystitis is on the rise [3]. Its early clinical
symptoms mainly include abdominal pain, belching, vom-
iting, and other symptoms of hepatogenic dyspepsia [4].
Complications occur most often in acute attacks of chole-
cystitis and pancreatitis, and about 25% of patients develop
bacterial infections, caused by obstruction of the cystic duct
or common bile duct, which seriously endanger the health
and daily life of the patient. Most patients with chronic
cholecystitis are accompanied by gallbladder stones, also
known as cholelithiasis [5], a condition in which stones are
found in the biliary system, such as the gallbladder or bile
ducts, with the typical symptoms of biliary colic. Epide-
miological data show that nearly 70% of patients with
chronic cholecystitis have gallbladder stones; therefore, the
combination of chronic cholecystitis with gallbladder stones
has received much attention in recent years, and timely and
effective interventions are essential to improve the outcome
and prognosis of patients’ lives [6–8].
2 Evidence-Based Complementary and Alternative Medicine
Oral lithotripsy may be considered in symptomatic
patients who are not candidates for surgery and have
cholesterol stones assessed by abdominal ultrasonography as
having normal gallbladder function and negative radio-
graphs [9]. Ursodeoxycholic acid (UDCA) is currently the
only bile acid drug approved by the US FDA for the non-
surgical treatment of gallstones [10]. Patients with chronic
cholecystitis often suffer from dyspepsia, and in the early
stages of dyspepsia, medications such as azintamide or other
pancreatic enzymes can be used to improve the symptoms
[11]. Patients with chronic cholecystitis usually do not re-
quire antibiotics. However, it is important to use antibiotics
appropriately when the patient has a combination of un-
derlying diseases, especially if there is impairment of liver or
kidney function [12]. However, when surgery is indicated,
surgical removal of the gallbladder is the treatment of choice
[13]. Cholecystectomy is the most common procedure in
biliary surgery for various acute and chronic cholecystitis,
symptomatic gallbladder stones, and gallbladder augmen-
tation lesions, and its long-term outcomes are considered
satisfactory in most cases. Cholecystectomy consists of open
cholecystectomy and laparoscopic cholecystectomy [14–16].
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With advances in medical technology, both surgical pro-
cedures are effective in the treatment of patients with
gallbladder stones combined with chronic cholecystitis, but
comparative analyses of their treatment outcomes and
postoperative quality of life are inadequate due to the lack of
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standardized and universally validated tools [17].
Accordingly, the present study was to assess the treat-
ment outcome and postoperative quality of life of patients
with gallbladder stones and chronic cholecystitis after open
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cholecystectomy and laparoscopic cholecystectomy to pro-
vide a reference for clinical surgical alternatives.
2. Materials and Methods
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2.1. Research Subjects. Between 2018 and 2020, 108 patients
with gallbladder stones and chronic cholecystitis treated in
our hospital were assessed for eligibility and randomly
recruited. )ey were concurrently assigned (1 : 1) to a control
group or a study group. )e study/research was approved by
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the Ethics Committee of the Affiliated Hospital of Jiangnan
University, No. j29879.
2.2. Inclusion and Exclusion Criteria
2.2.1. Inclusion Criteria
(1) All diagnosed with gallbladder stones and chronic
cholecystitis [18]
(2) With consciousness and no combined psychiatric
diseases
(3) With no autoimmune system diseases or acute bil-
iary pancreatic diseases
2.2.2. Exclusion Criteria
(1) With cardiac, hepatic, renal, and other important
organ insufficiencies
(2) With surgical-related contraindications
(3) With coagulation disorders
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2.3. Methods. Patients in both groups were in the supine
position. Open cholecystectomy was performed for patients
in the control group [19]. After general anaesthesia, a 10 cm
long incision is made in the right upper abdomen through
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the rectus abdominis muscle. )e abdominal wall is incised
into the abdominal cavity in sequence, and the operation is
extended with a large “S” shaped hook. )e gallbladder is
removed in a cisreverse fashion, the exudate is aspirated with
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sterile gauze, a drainage tube is placed in the abdominal wall,
the abdominal cavity is cleaned, and the incision is closed
layer by layer. Postoperative gastrointestinal decompression
and antiinfective treatments were given. )e patients in the
study group underwent laparoscopic cholecystectomy [7].
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)e patient was given intravenous general anaesthesia with
tracheal intubation preoperatively, and a 1 cm curved in-
cision was made below the umbilicus after the routine es-
tablishment of a CO2 pneumoperitoneum, followed by the
placement of a 10 mm Trocar to examine the abdominal
cavity condition. A 1 cm incision was made 4 cm below the
glabella as the main operating port, where a 10 mm Trocar
was placed. A 5 mm Trocar was placed 2 cm below the right
rib in the anterior axillary line and 2 cm below the rib in the
right midclavicular line to establish a secondary operating
port, and the gallbladder and the cystic duct were fully
exposed and separated. )e gallbladder was resected under
laparoscopic assistance and removed through the main
operating port. )e surgical area was irrigated, and the
incision was sutured sequentially. Postoperatively, routine
gastrointestinal decompression and anti-infective treatment
were given.
2.4. Outcome Measures
① Surgical indices: the surgical conditions (including
the duration of surgery, intraoperative bleeding, time
to first postoperative bowel movement, and post-
operative hospital stay) of the two groups were
recorded and compared.
② Inflammatory factors: fasting venous blood was
collected before and 2 d after surgery in the two
groups, respectively, to separate serum. Serum
C-reactive protein (CRP) was determined by the
scattering turbidimetric method, and interleukin-6
(IL-6), and interleukin-8 (IL-8) were determined by
the enzyme-linked immunosorbent assay (EusA).
③ Complications: the occurrence of surgical compli-
cations (including incisional infection, bile duct
bleeding, abdominal infection, pulmonary infection,
and intrahepatic cholestasis) was recorded separately
in both groups to calculate the incidence. Compli-
cation rate � number of people with complications/
total number of people × 100%.
④ Quality of life [20]: the quality of life of the two
groups was analysed by comparing the scores of the 3
Evidence-Based Complementary and Alternative Medicine 3

Table 1: Comparison of baseline characteristics (x ± s).

Gender (male/ Age Mean age Duration of Mean duration of Stone diameter Mean diameter
Groups n
female) (year) (year) disease (year) disease (year) (cm) (cm)

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Study
54 28/26 58–77 59.23 ± 3.78 1–5 3.02 ± 0.82 2.87–18.67 5.23 ± 2.17
group
Control
54 27/27 55–79 59.18 ± 4.05 1–5 3.18 ± 0.65 3.25–20.02 5.48 ± 1.99
group
t value — — — 0.066 — 1.124 — 0.624

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P value — — — 0.948 — 0.264 — 0.534

Table 2: Comparison of surgical conditions (x ± s).

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Intraoperative Time to first post-operative Postoperative
Groups n Duration of surgery (min)
bleeding volume (ml) bowel movement (h) hospital stay (d)
Study group 54 88.25 ± 25.63 75.83 ± 7.23 37.85 ± 3.17 5.02 ± 3.21
Control group 54 120.98 ± 31.65 119.16 ± 14.41 58.25 ± 5.21 8.74 ± 3.11
t value — 5.906 19.750 24.581 6.116

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P value — ＜0.001 ＜0.001 ＜0.001 ＜0.001

domains of physical function, psychological function, laparoscopic cholecystectomy patients (16.18 ± 3.21,

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and social function of the patients. Each dimension 55.74 ± 6.18, 22.57 ± 5.67) than in open cholecystectomy
had 5 assessment factors, and the scores were pro- patients (26.24 ± 2.87, 64.87 ± 4.96, 41.68 ± 5.21) (P < 0.05)
portional to the quality of life. (Table 3).

2.5. Statistical Analysis. SPSS 22.0 software was used for data 3.4. Complications. Compared with open cholecystectomy,

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analyses. )e count data were expressed as (n (%)) and
processed using the chi-square test, and the measurement
data were expressed as (x ± s) and processed using the t-test.
Differences were considered statistically significant at
laparoscopic cholecystectomy had a significantly lower
complication rate (3.56%) (1 (1.85%) incisional infection, 1
(1.85%) bile duct haemorrhage, and 1 (1.85%) intrahepatic
cholestasis) and (24.07%) (5 (9.25%) incisional infections, 2

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P < 0.05. (3.71%) bile duct haemorrhages, 1 (1.85%) abdominal in-
fection) cases, 1 (1.85%) pulmonary infection, 4 (7.41%)
3. Results cases of intrahepatic cholestasis) (P < 0.05) (Table 4).
3.1. Baseline Information. )e baseline characteristics of the

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patients in the study group (28 males and 26 females, aged
58–77 years, mean age of (59.23 ± 3.78) years, duration of
disease of [1–5] years, mean duration of disease of
(3.02 ± 0.82) years, the stone diameter of (2.87–18.67) mm,
3.5. Quality of Life. Patients’ physical, psychological, and
social functioning scores were significantly higher after
laparoscopic cholecystectomy (86.23 ± 5.96, 87.45 ± 5.12,
and 83.17 ± 4.91) than after open cholecystectomy

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and mean diameter of (5.23 ± 2.17) mm) were comparable
with those in the control group (27 males and 27 females,
aged 55–79 years, mean age of (59.18 ± 4.05) years, duration
of disease of [1–5] years, mean duration of disease of
(3.18 ± 0.65) years, the stone diameter of (3.25–20.02) mm,
and mean diameter of 5.48 ± 1.99 mm) (P > 0.05) (Table 1).
3.2. Surgical Conditions. Compared to open cholecystec-
tomy (120.98 ± 31.65, 119.16), laparoscopic cholecystectomy
was associated with shorter operative time, intraoperative
bleeding, time to first postoperative bowel movement, and
postoperative hospital stay (88.25 ± 25.63, 75.83 ± 7.23,
37.85 ± 3.17, 5.02 ± 3.21) ± 14.41, 58.25 ± 5.21, 8.74 ± 3.11)
(P < 0.05) (Table 2).
3.3. Inflammatory Response. All eligible patients had com-
parable levels of inflammatory factors prior to cholecys-
tectomy (P > 0.05). CRP, IL-6, and IL-8 levels were lower in
(73.84 ± 5.17, 76.77 ± 4.84, and 73.65 ± 5.95) (P < 0.05)
(Table 5).
4. Discussion
Patients with gallbladder disease usually present with a long
duration, acute and rapid progression, and are highly sus-
ceptible to various complications if not treated promptly.
Long-term episodes of acute or subacute cholecystitis may
lead to chronic cholecystitis disease. Gallbladder stones are
the main cause of chronic cholecystitis. Stones can lead to
repeated obstruction of the gallbladder duct, causing damage
to the gallbladder mucosa, resulting in recurrent inflam-
matory responses in the gallbladder wall, scar formation, and
gallbladder dysfunction [21]. Chronic nonlithiatic chole-
cystitis is mainly caused by bacterial infections of enteric
origin, where intestinal bacteria can pass through the bile
duct to the gallbladder, or through the blood or lymphatic
route to the gallbladder [22]. )e treatment of patients with
4 Evidence-Based Complementary and Alternative Medicine

Table 3: Comparison of inflammatory factors levels (x ± s).

CRP (mg/L) IL-6 (mg/L) IL-8 (mg/L)
Groups n
Before treatment After treatment Before treatment After treatment Before treatment After treatment

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Study group 54 6.25 ± 1.98 16.18 ± 3.21 46.21 ± 5.34 55.74 ± 6.18 10.17 ± 3.74 22.57 ± 5.67
Control group 54 6.11 ± 2.06 26.24 ± 2.87 46.18 ± 5.29 64.87 ± 4.96 10.23 ± 3.65 41.68 ± 5.21
t value — 0.360 17.168 0.029 8.467 0.084 18.237
P value — 0.720 ＜0.001 0.977 ＜0.001 0.933 ＜0.001

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Table 4: Comparison of complications (%).
Incisional Bile duct Abdominal Pulmonary Intrahepatic
Groups n Incidence
infection bleeding infection infection cholestasis

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Study group 54 1 (1.85) 1 (1.85) 0 (0.00) 0 (0.00) 1 (1.85) 3 (5.56)
Control
54 5 (9.25) 2 (3.71) 1 (1.85) 1 (1.85) 4 (7.41) 13 (24.07)
group
x2 value — — — — — — 7.337
P value — — — — — — 0.007

Groups
Study group
Control group
t value
P value
n
54
54
—
—

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Table 5: Comparison of quality of life (x ± s).
Physical function
86.23 ± 5.96
73.84 ± 5.17
11.540
＜0.001 C
Psychological function
87.45 ± 5.12
76.77 ± 4.84
11.139
＜0.001
Social function
83.17 ± 4.91
73.65 ± 5.95
9.069
＜0.001

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cholecystitis combined with gallstones was mostly per-
formed by open surgery previously [23], which could achieve
satisfactory therapeutic results but is associated with dis-
advantages such as significant trauma, long operative time,
invasive and has a greater impact on the patient’s tissues,
endocrine system, and associated cytokines, whereas lapa-
roscopic cholecystectomy has a small surgical incision, a low
incidence of bile duct injury, and a low incidence of bile

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large intraoperative blood volume, and a negative impact on
patients’ gastrointestinal function [24]. In recent years,
laparoscopic cholecystectomy has been widely used in the
clinical treatment of patients with chronic cholecystitis and
gallbladder stones [25, 26]. As the gold standard for the
leakage from the stump. )e gallbladder duct is delayed, and
there is less postoperative intraabdominal bleeding and less
interference with organ function. In addition, laparoscopic
cholecystectomy had a significantly lower complication rate
and a significantly higher quality of life score compared to

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treatment of gallbladder disease, laparoscopic cholecystec-
tomy has the advantages of being minimally invasive, small
incision, less pain, and quicker postoperative recovery, and
is conducive to preserving the contractile function of the
open cholecystectomy (P < 0.05). )e cure rate of laparo-
scopic cholecystectomy exceeded 98%, with no absolute
contraindications, small surgical incisions, and rapid post-
operative recovery, reducing the incidence of postoperative

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gallbladder [27, 28]. In recent years, extensive research has
been undertaken on the treatment of gallbladder stones and
chronic cholecystitis [29].
)e results of this study showed that laparoscopic
cholecystectomy was associated with shorter operative time,
intraoperative bleeding, time to first postoperative bowel
movement, and shorter postoperative hospital stay com-
pared to open cholecystectomy (P < 0.05), suggesting the
advantages of laparoscopic cholecystectomy. )is was at-
tributed to the clear laparoscopic view of the gallbladder
surface and surrounding tissues. )e clear surgical view
combined with the advanced endoscopic equipment max-
imises the noninvasive nature of the human tissue and
speeds up postoperative recovery. )e patients given lapa-
roscopic cholecystectomy showed lower levels of CRP, IL-6,
and IL-8 versus those given open cholecystectomy
(P < 0.05), indicating that laparoscopic cholecystectomy
results in less trauma and a milder inflammatory response.
)e reason for this is that open cholecystectomy is highly
complications and improving the quality of life of patients.
Investigated the clinical efficacy of laparoscopic cholecys-
tectomy versus open cholecystectomy and found that lap-
aroscopic cholecystectomy is characterized by less trauma,
less body impact, and faster post-operative recovery versus
open cholecystectomy, which is consistent with the results of
the present study.
Chronic cholecystitis belongs to the category of hypo-
chondriac pain in TCM, with the disease located in the
gallbladder and liver in a close relationship, often accom-
panied by liver qi stagnation, liver and gallbladder dampness
and heat, stasis, and blood blockage [30]. Drugs such as Chai
Hu to clear the liver, Yu Jin to clear heat and dampness,
Chuan Xiong to activate blood circulation and remove blood
stasis, Qian Cao and Cang Zhu to clear heat and dampness,
Bai Shao to soften the liver and relieve pain, Yuan Hu Suo to
move Qi and blood to relieve pain, Hai Jin Sha to clear heat
and dampness and drain stones, and Citrus Aurantium to
broaden the middle and move Qi to facilitate the draining of
Evidence-Based Complementary and Alternative Medicine
liver Qi [31]. Different prescriptions should be used
according to the type of Chinese medicine, and it should be
emphasized that in the actual symptoms of chronic chole-
cystitis, the main focus is on eliminating evil, such as clearing
heat and dampness, soothing the liver and bile, and moving
Qi and invigorating blood, while in the deficiency symp-
toms, the main focus is on helping the righteous, such as
strengthening the spleen and benefiting Qi, nourishing Yin
and softening the liver, and can also be combined with
Chinese medicine specialties, such as acupuncture and
moxibustion ear points, medication paste on the abdomen,
and acupoint burial [30–32].
But our experiments still have limitations. First of all, we
need long-term regular follow-up visits to determine the
prognostic effect. Second, we need to expand the scope of the
trial and the sample size. Although sensitive and responsive
instruments exist for measuring the quality of life after
cholecystectomy, more research is needed to identify
modifications that may lead to significant improvements.
5. Conclusion
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To sum up, laparoscopic cholecystectomy provides better
surgical results, mitigates the inflammatory response, lowers
the incidence of complications, and improves the quality of
life of patients versus open cholecystectomy, so it is worthy
of application in clinical treatment.
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Data Availability
All data generated or analysed during this study are included
in this published article.
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Conflicts of Interest
)e authors declare that they have no conflicts of interest.
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