Micro-incision of the Cystic Duct Confluence Technique in Laparoscopic Choledochal Exploration Lithotomy:Report of 267 Cases
10.3969/j.issn.1009-6604.2024.04.002
- VernacularTitle:胆囊管汇入部微切开技术行腹腔镜胆总管探查取石术267例报告
- Author:
Nan LIU
1
;
Qi LIU
;
Xiaoyong LI
;
Tingting WANG
;
Dexing CHEN
Author Information
1. 吉林省前卫医院普外科,长春 130012
- Keywords:
Cystic duct confluence;
Laparoscopy;
Choledochal exploration lithotomy;
Choledocholithiasis
- From:
Chinese Journal of Minimally Invasive Surgery
2024;24(4):245-249
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of laparoscopic common bile duct exploration(LCBDE)by means of micro-incision of the cystic duct confluence.Methods From January 2020 to March 2023,267 cases of cholecystolithiasis complicated with choledocholithiasis were given LCBDE by means of micro-incision through the cystic duct confluence.An incision was made along the inferior wall of the cystic duct to the conjunctive part of the common bile duct,and the lateral wall of the common bile duct was cut for 3-5 mm longitudinally.The bile duct exploration and stone extraction were completed under choledochoscope.Primary suture was performed.An abdominal drainage tube was placed.Results The operations were completed in all the 267 cases and the common bile duct stones were thoroughly removed.The operation time was 45-128 min(mean,96.5±9.7 min),the postoperative drainage indwelling time was 3-13 d(mean,5.1±1.2 d),and the postoperative hospitalization time was 5-13 d(mean,6.8±1.1 d).Biliary leakage occurred in 4 cases and was cured after abdominal drainage for 9-11 d.Postoperative fever was noted in 1 1 cases and was treated with anti-inflammatory therapy for 1-3 d.Abdominal abscess developed in 2 cases and was cured by abdominal drainage.A total of 242 cases(90.6％)were followed up for 6-39 months(median,11 months),of which 66 cases were followed up for more than or equal to 36 months.Residual stones were found in 2 cases,stone recurrence was noted in 2 cases,and no choledochal stenosis was found.Conclusion Laparoscopic lithotomy with micro-incision of the cystic duct confluence has a good clinical effect in the treatment of choledocholithiasis.
