Laparoscopic cholecystectomy and common bile duct exploration in patients with previous subtotal gastrectomy
10.3760/cma.j.issn.1007-8118.2012.06.009
- VernacularTitle:胃大部切除术后患者实施腹腔镜胆囊切除和胆总管探查术的体会
- Author:
Zhiliang CHEN
;
Peitu REN
;
Baochun LU
;
Jianfeng FANG
;
Jianhui YANG
;
Zhiyang ZHU
- Publication Type:Journal Article
- Keywords:
Gastrectomy;
Cholecystectomy;
aparoscopic;
Common bile duct exploration
- From:
Chinese Journal of Hepatobiliary Surgery
2012;18(6):427-429
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and technique in laparoscopic cholecystectomy and exploration of common bile duct (CBD) in patients who have previous subtotal gastrectomy.Methods From January 2001 to October 2010,22 patients who had a history of subtotal gastrectomy received laparoscopic cholecystectomy and CBD exploration in our hospital.In addition,these patients received cholangioscopic lithotomy,electrohydraulic lithotripsy,T-tube drainage,or primary suturing of the CBD wound.Results The procedures were completed successfully in 18 patients.In 4 patients,conversion to laparotomy was necessary because of multiple stones in a stenosed CBD (n=1),severely congested CBD wall with edema (n=1),CBD carcinoma associated with impacted stones (n=1) or Mirzzi syndrome (n =1).T tube drainage was employed in 16 patients,and primary suturing in 2 patients at the end of the operation.There was no hemorrhage,biliary leakage or abdominal infection.At a mean follow-up of 13 (range 3 to 60) months there was no residual stone,biliary stenosis or cholangitis.In 3 patients Stone recurred,and another 3 patients were lost to follow-up.Conclusions A history of subtotal gastrectomy is not a contradiction to laparoscopic cholecystectomy and CBD exploration.With choledocoscopy,surgery can be safe and feasible even for patients with previous gastectomy.
