Objective To investigate the clinical effect of laparoscopic cholecystectomy (LC) via cystic plate approach in patients with AIDS complicated by cholecystolithiasis. Methods A retrospective analysis was conducted on clinical data of 125 AIDS patients with cholecystolithiasis， who were grouped into a control group (conventional three-port anterograde LC, n=60) and an observation group (LC via cystic plate priority dissection approach, n=65) based on surgical approach. Perioperative parameters (operative duration, intraoperative blood loss, time to first flatus and postoperative hospital stay) and the occurrence of postoperative complications were compared between the two groups. Levels of immune function markers(CD3+ T lymphocytes, CD8+ T lymphocytes and CD3+ T lymphocytes/CD8+ T lymphocytes ratio), liver function markers [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBiL), alkaline phosphatase (ALP)] and inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6)] were compared at preoperative day 1 and postoperative day 3. Patients were followed up for 6 months postoperatively, and the occurrence of long-term adverse events was statistically analyzed and compared between the two groups. Results There was no statistically significant difference in operative duration between the two groups (P>0.05); however, the observation group exhibited lower intraoperative blood loss, a shorter time to first flatus, and a shorter postoperative hospital stay compared with the control group (P<0.05); the overall incidence of postoperative complications was lower in the observation group than in the control group (P<0.05). On postoperative day 3, the counts of CD3+ and CD8+ T-lymphocytes, as well as the CD3+ T lymphocytes/CD8+ T lymphocytes ratio decreased in both groups compared with preoperative day 1, and all these immune markers were significantly better in the observation group (P<0.05); the levels of serum ALT, AST, TBiL, ALP, CRP and IL-6 were evaluated in both groups relative to preoperative day 1, whereas corresponding levels were markedly lower in the observation group (P<0.05). At the 6-month postoperative follow-up, there was no statistically significant difference in the overall incidence of adverse events between the two groups (P>0.05). Conclusion Application of LC via cystic plate priority dissection approach,facilitates postoperative recovery and reduces postoperative complication risks when adopted for AIDS patients with cholecystolithiasis, while preserving early postoperative immune and liver function and attenuating systemic inflammatory stress response.

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