"The feasibility of ""one-stage and two classification"" method to treat concomitant gallbladder stones and common bile duct stones"
10.3760/cma.j.issn.1007-8118.2017.08.007
- VernacularTitle:“一步二分类法”治疗胆囊结石合并胆总管结石的可行性
- Author:
Hua SHEN
;
Sheng YU
;
Haigen JIANG
;
Jun LU
;
Yan WANG
;
Yunhai WEI
- Keywords:
Laparoscopic cholecystectomy;
Endoscopic retrograde cholangiopancreatography (ERCP);
Laparoscopic common bile duct exploration;
Gallstones;
Common bile duct stone
- From:
Chinese Journal of Hepatobiliary Surgery
2017;23(8):526-529
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the efficacy and feasibility of the one-stage and two classification method to treat concomitant gallbladder stones and common bile duct stones.Methods 56 consecutive patients with concomitant gallbladder stones and common bile duct stones in Central Hospital of Huzhou were treated with the one-stage and two classification method from January 2013 to January 2017.According to the size and quantity,common bile duct stones were divided into difficult stones and non difficult stones.In plan A (n =35),endoscopic stone clearance and laparoscopic cholecystectomy were undertaken in a single operation to treat non difficult stones,In plan B (n =21),laparoscopic cholecystectomy and CBD exploration without T-tube insertion were undertaken in a single operation to treat difficult stones.The operation success rate,postoperative complications,hospitalization stay and follow-up outcomes were analyzed.Results Fifty-six patients were enrolled in the study.Fifty-one patients were treated by the one-stage and two classification method.Among them,thirty-two patients followed treatment plan A.Three patients were convened to plan B because of failure of bile duet intubation.Nineteen patients were treated by plan B.One patient was converted to laparotomy,and another underwent T-tube drainage.The incidence of complication was 7.1％.Post-ERCP pancreatitis happened in one patient.Post ERCP bleeding happened in another patient (1.6％).Bile leakage occurred in one patient,and incision infection occurred in one patient.There were no deaths.During a follow-up of 6-24 months,no stone recurrence and bile duct stenosis were observed.Conclusion The one-stage and two classification method was an effective and feasible alternative to manage concomitant gallbladder stones and common bile duct stones.
