中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 11
Nov.  2017
Turn off MathJax
Article Contents

Clinical analysis of laparoscopic combined with choledochoscope via the cystic duct for choledocholithiasis

DOI: 10.3969/j.issn.1001-5256.2017.11.024
  • Received Date: 2017-05-12
  • Published Date: 2017-11-20
  • Objective To explore the clinical application of laparoscopic transcystic common bile duct exploration.Methods From Jan2014 to Dec 2015, laparoscopic transcystic common bile duct exploration was performed in 52 cases of cholecystolithiasis.The therapeutic effects of cases were studied.Results Among them, 40 cases were performed operation successfully.The success rate of operation was 76.92%.7 cases were changed to laparoscopic common bile duct incision exploratory stone operation.5 cases were performed common bile duct incision nephrolithotomy, and the transfer rate was 9.62%.43 cases were toke stone success at a time in all of patients.The success removed rate was 82.69%.The last 9 patients included 8 cases performed laparoscopic transcystic common bile duct exploration and 1 case performed laparoscopic common bile duct incision exploratory stone operation.All cases were placed abdominal cavity drainage tube pulled out after 3-10 days.Biliary leakage occurred in 1 patients performed laparoscopic common bile duct incision exploratory stone operation, and it was cured after conservative treatment.No biliary tract infection, biliary tract bleeding complications occurred.The average hospitalization time was (8.24±2.52) days.All patients were followed up 1 year.No extrahepatic bile duct stones were found by B-ultrasonic and MRCP, and bilirubin were normal.Conclusion Laparoscopic transcystic common bile duct exploration has positive clinical efficacy with small trauma, quick rever, less complications, safety and effective.etc.But its indications must be grasped strictly in clinical promotion.

     

  • loading
  • [1]YANG DX, YANG MW, ZHANG Y, et al.Clinical application of laparoscopy combined with choledochoscopy for treatment of gallstones with common bile duct stones in primary hospitals[J].J Clin Hepatol, 2014, 30 (11) :1132-1134. (in Chinese) 杨东晓, 杨明稳, 张勇, 等.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石在基层医院的应用体会[J].临床肝胆病杂志, 2014, 30 (11) :1132-1134.
    [2]YE ZD, HUANG D, WENG JF, et al.Application of combined laparoscopy and choledochoscopy in treatment of choledocholithiasis in patients over 80 years of age:therapeutic results and postoperative follow-up[J].Chin J Gen Surg, 2016, 25 (2) :298-301. (in Chinese) 叶志东, 黄迪, 翁杰锋, 等.80岁以上超高龄胆总管结石患者应用腹腔镜与胆道镜双镜联合手术疗效与术后随访[J].中国普通外科杂志, 2016, 25 (2) :298-301.
    [3]SHANG XW.Comparative analysis of laparoscopic exploration of common bile duct via the cystic duct bile duct versus choledochotomy in the treatment of extrahepatic bile duct stones[J].Chin J Gen Surg, 2014, 23 (8) :1144-1146. (in Chinese) 尚修万.腹腔镜下经胆囊管胆道探查术与胆总管切开探查术治疗肝外胆管结石的疗效比较[J].中国普通外科杂志, 2014, 23 (8) :1144-1146.
    [4]SUN M, LIU XQ, TENG YS, et al.Laparoscopic transcystic common bile duct exploration:A clinical analysis of 68 cases[J].Chin J Pract Surg, 2013, 33 (9) :776-777, 786. (in Chinese) 孙敏, 刘训强, 腾毅山, 等.腹腔镜下胆道镜经胆囊管胆道探查取石术68例临床分析[J].中国实用外科杂志, 2013, 33 (9) :776-777, 786.
    [5]WEN ZQ, SONG Y, ZHANG YM, et al.Clinical application of laparoscopy combined with choledochoscopy and duodenoscopy in treatment of gallstones complicated by intra-and extrahepatic bile duct stones[J].J Clin Hepatol, 2016, 32 (6) :1145-1148. (in Chinese) 温治强, 宋越, 张耀明, 等.腹腔镜联合胆道镜、十二指肠镜治疗胆囊结石合并肝内外胆管结石的效果观察[J].临床肝胆病杂志, 2016, 32 (6) :1145-1148.
    [6]WENNER DE, WHITWAM P, ROSSER J, et al.A stone extraction facilitation device to achieve an improved technique for performing LCBDE[J].Surg Endosc, 2005, 19 (1) :120-125.
    [7]LI Y, WU Z, YAO YM, et al.Laparoscopic trans-cystic bile duct exploration in the management of choledocholithiasis[J].Chin JMin Inv Surg, 2016, 16 (1) :47-49. (in Chinese) 李宇, 仵正, 姚英民, 等.腹腔镜经胆囊管胆总管探查取石术的临床应用[J].中国微创外科杂志, 2016, 16 (1) :47-49.
    [8]QU SX, MENG XD, FU QJ, et al.Vale of laparoscopic transcystic duct common bile duct exploration in patients of gallstones with secondary choledochotithiasis[J].J Hepatobiliary Surg, 2016, 24 (3) :217-218. (in Chinese) 屈顺喜, 孟晓东, 付庆江, 等.腹腔镜下经胆囊管取石治疗胆囊结石合并继发胆总管结石的临床价值[J].肝胆外科杂志, 2016, 24 (3) :217-218.
    [9]REINDERS JS, GOUMA DJ, UBBINK DT, et al.Transcystic or transductal stone extraction during single-stage treatment of choledochocystolithiasis:a systematic review[J].World J Surg, 2014, 38 (9) :2403-2411.
    [10]LEI HF.Effect comparison of laparoscopic transcystic common bile duct explo-ration and common bile duct incision exploration in the treatment of ex-trahepatic bile duct stone[J].China Med Herald, 2015, 12 (29) :89-92. (in Chinese) 雷海峰.腹腔镜下经胆囊管胆道探查术与胆总管切开探查术治疗肝外胆管结石的效果比较[J].中国医药导报, 2015, 12 (29) :89-92.
    [11]WANG ZC, LUO H.Literature analysis of 1186 cases of laparoscopic transcystic common bile duct exploration[J].Chin J Gen Surg, 2012, 21 (8) :941-945. (in Chinese) 王舟翀, 罗浩.腹腔镜下经胆囊管途径胆总管探查手术1186例文献分析[J].中国普通外科杂志, 2012, 21 (8) :941-945.
    [12]CHEN XM, ZHANG Y, CAI HH, et al.Transcystic approach with micro-incision of the cystic duct and its confluence part in laparoscopic common bile duct exploration[J].J Laparoendosc Adv Surg Tech A, 2013, 23 (12) :977-981.
    [13]PENG Y, WANG LX, XU Z, et al.Laparoscope combined with choledochoscope for cholecystolithiasis and choledocholithiasis through a micro-incision at linking part of cystic duct[J].Chin J Min Inv Surg, 2015, 15 (3) :224-227. (in Chinese) 彭颖, 王立新, 徐智, 等.腹腔镜联合胆道镜经胆囊管汇入部微切开治疗胆囊结石合并胆总管结石[J].中国微创外科杂志, 2015, 15 (3) :224-227.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1980) PDF downloads(376) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return