The role of ENBD in laparoscopic exploration of common bile duct
- VernacularTitle:经内镜鼻胆管引流术在腹腔镜胆管探查中的作用
- Author:
Wen LI
;
Jundu FAN
;
Lei SHI
- Publication Type:Journal Article
- Keywords:
Endoscopic nasobiliary drainage;
Bile duct stone;
Laparoscopic common bile duct exploration;
Choledochoscopy
- From:
Chinese Journal of Digestive Endoscopy
1996;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the role of endoscopic nasobiliary drainage ( ENBD) of bile duct instead of T tube drainage during laparoscopic common bile duct exploration (LCBDE). Methods All the patients accepted ENBD before LCBDE / laparoscopic cholecystectomy (LC) + LCBDE. During the operation the stones were extracted by choledochoscopy or crashed with electrohydraulic lithotripsy. After removing all of the biliary stones, the nasobiliary tube still remained in the common bile duct, then primary closure of the exploration wound on the duct wall was made, and with routine abdominal drainage. After operation , radiography of the nasobiliary tube was taken to investigate if there were any residual stones or leakage in the bile duct remained. Subsequently the drainage tube and nasobiliary tube were respectively removed as indicated. Results Totally 43 cases accepted ENBD preoperatively, after 6. 1 days LCBDE was performed, in 36 cases (83. 7% ) the operation was successfully using nasobiliary drainage and primary closure of the duct wound. Postoperative radiography of the duct system through the nasobiliary tube showed only in one case (2. 6% ) a small stone left which was then extracted under ERCP. There were no bile duct stricture and bile leakage, so the nasobiliary tube was removed smoothly. Seven cases ( 18. 6% ) were transferred to open abdominal exploration, 2 of them still kept the nasobiliary tube and the choledochal incisions were primary closed. Totally 38 patients (88.4% ) were successfully drained by ENBD. The abdominal drainage and nasobiliary tubes were removed in average of 3.2 and 6.7 days respectively without complications. Conclusion ENBD is an effective and safe procedure for bile duct drainage in LCBDE. It has the advantage of minimal trauma, short drainage period and rare complications. It suggested that this procedure should be a new satisfied way in treatment of bile duct stones.
