Sequential duodenoscopic-laparoscopic management for cholelithiasis: Analysis of 2 248 cases
- VernacularTitle:十二指肠镜、腹腔镜序贯治疗胆石症2248例分析
- Author:
Fuming YING
;
Xuefeng FENG
;
Tianyi FAN
- Publication Type:Journal Article
- Keywords:
Duodenoscopy;
Laparoscopy;
Cholelithiasis;
Diagnosis;
Treatment
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the value of sequential duodenoscopic-laparoscopic treatment in patients with cholelithiasis. Methods Clinical data of 2 248 cases of cholelithiasis treated with sequential duodenoscopic-laparoscopic plan from January 2000 to December 2004 were retrospectively reviewed. Results Duodenoscopy indicated the confirmative diagnosis of gallbladder stones in 1 817 cases and gallbladder stones with associated common bile duct stones in 431 cases. Among 2 021 cases diagnosed as having gallbladder stones by B-ultrasonography: endoscopic retrograde cholangiopancreatography (ERCP) was performed in 690 cases, 213 of which were found having associated common bile duct stones; intraoperative cholangiography (IOC) was conducted in 85 cases, 10 of which were found presenting common bile duct stones; residual stones in the common bile duct after laparoscopic cholecystectomy (LC) were noted in 6 cases which were cured by endoscopic sphincterotomy (EST). Among 227 cases diagnosed as having gallbladder stones combined with common bile duct stones by B-ultrasonography, the diagnosis of common bile duct stones were confirmed by ERCP in 202 cases. Out of the 2 248 cases, 1 817 cases underwent the LC, 395 cases received EST and LC, and 36 cases were given the laparoscopic bile duct exploration (LBDE) (the bile duct was closed by primary suture in 26 cases and a T-tube was left in the bile duct in 10 cases). The 6 cases of residual stones in the bile duct were cured with EST postoperatively. A total of 28 cases required a conversion to open surgery (1.2%), and complications occurred in 52 cases (2.3%). Conclusions Sequential duodenoscopic- laparoscopic treatment for cholelithiasis offers a low residual stone rate and a high success rate.
