Abstract: Objective To explore the value of different anatomical approaches in the prevention of biliary tract injury and its clinical application in laparoscopic complex cholecystectomy. Methods From January 2019 to March 2022, Huai’an Huaiyin Hospital and Huai’an Fifth People’s Hospital were selected. A total of 125 patients undergoing laparoscopic complex cholecystectomy were divided into control group (n=65) and observation group (n=60) according to random number table method. Patients in the control group underwent conventional surgical approach for laparoscopic cholecystectomy, while patients in the observation group underwent laparoscopic cholecystectomy through V-shaped anatomical approach of the gallbladder triangle. The operation conditions, relevant laboratory examination indexes, incidence of complications and postoperative recovery were compared between the two groups. Results The operation time, intraoperative blood loss and conversion rate of the observation group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). After operation, the levels of body temperature, aspartate aminotransferase (AST), white blood cell (WBC), direct bilirubin (DBIL), alanine aminotransferase (ALT), indirect bilirubin (IBIL) and neutrophil percentage (NEU%) in the two groups were lower than those before operation, and the differences were statistically significant (P<0.05). After operation, there were no significant differences in body temperature, AST, WBC, DBIL, ALT, IBIL and NEU% between the two groups (P>0.05). There was no significant difference in postoperative complications between the two groups (P>0.05). The average postoperative drainage tube indwelling time, postoperative exhaust time, hospitalization time and hospitalization cost of the observation group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). Conclusion The gallbladder triangle V-shaped anatomical approach in the process of laparoscopic complex cholecystectomy can reduce the operation time and conversion rate to open surgery, reduce the incidence of complications such as biliary tract injury and biliary leakage, reduce the cost of hospitalization, the curative effect is significant, worthy of clinical application.

Key words: V font anatomical approach, laparoscope, complex cholecystectomy, biliary tract injury