Complications after bile duct exploration for secondary choledocholithiasis using a combined laparoscopic and choledochoscopic approach
10.3760/cma.j.issn.1007-8118.2011.09.012
- VernacularTitle:腹腔镜联合胆道镜治疗继发性胆道结石术后并发症分析
- Author:
Conghui YU
;
Jianmin MEI
;
Changzhong YU
;
Junbo YAO
;
Ronghua YANG
;
Hongfeng NIE
- Publication Type:Journal Article
- Keywords:
Gallstones;
Secondary choledocholithiasis;
Minimal invasive methods
- From:
Chinese Journal of Hepatobiliary Surgery
2011;17(9):732-734
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the complications after laparoscopic bile duct exploration.MethodsTwo approaches for bile duct exploration were used in 105 patients: (1) laparoscopic transcystic common bile duct exploration (LTCBDE) was used for patients with gallstones with choledocholithiasis and cystic duct dilation. No T tube was used for drainage, (2) Laparoscopic common bile duct exploration (LCBDE) was used for patients with gallstones with choledocholithiasis but without cystic duct dilation. The common bile duct was sutured primarily without T tube drainage in those patients with a small number of stones. T tube drainage was used in those patients with many stones or severe edema at the lower end of the common bile duct. ResultsWe carried out LTCBDE+ LC in 70 patients and LCBDE+LC in 35 patients, 14 patients had T tube drainage and 21 patients had no T tubes in the latter group of patients. Postoperatively, there were ascites in 17 patients (LTCBDE 6 and LCBDE 11 ), biliary peritonitis in 5 patients (1 LTCBDE and 4 LCBDE), abdominal pain in 13 patients (LTCBDE 4 and LCBDE 9), and fever in 11 patients (LTCBD 3 and LCBDE 8). All the complications responded to conservative treatment. 14 patients in the LCBDE group had residual stones.Choledochoscopy was used to remove the residual stones.There was no pancreatitis. Conclusions Adequate preoperative workup, good clinical judgment and precise treatment skill help to reduce complication rates after operation for gallstones with choledocholithiasis.
