Laparoscopic ultrasound assisted hepatectomy in treatment of intrahepatic and extrahepatic bile duct stones
10.3760/cma.j.issn.1007-8118.2019.09.012
- VernacularTitle: 腹腔镜超声辅助精准肝切除治疗肝内外胆管结石
- Author:
Guowei LI
1
;
Jianfeng CAI
;
Nianyong YUAN
;
Zusheng YU
;
Yihong WEN
;
Junjie ZHANG
;
Wei DING
;
Qunfeng XIA
Author Information
1. Department of Hepatobiliary and Pancreatic Surgery, the First People's Hospital of Fuyang District, Hangzhou 311400, China
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Ultrasonography;
Hepatectomy;
Laparoscopic ultrasound;
Precise surgery;
Bile duct stone
- From:
Chinese Journal of Hepatobiliary Surgery
2019;25(9):685-688
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study laparoscopic ultrasound assisted hepatectomy in treatment of intrahepatic and extrahepatic bile duct stones.
Methods:The data of 52 patients with hepatolithiasis who underwent laparoscopic hepatectomy from May 2014 to January 2019 at the Fuyang District First People's Hospital in Hangzhou were analyzed retrospectively. There were 28 men and 24 women. The median age was 56 years. Operative laparoscopic ultrasonography was used to detect the location, size, distribution of stones and their relations to blood vessels. A total of 43 patients underwent anatomic hepatectomy, while 38 patients underwent choledochoscopic stone extraction. A " T" tube was used according to intraoperative conditions.
Results:Laparoscopic surgery was successfully carried out in 50 patients, while conversion to open surgery was required in 2 patients because of adhesions and bleeding. Laparoscopic ultrasonography revealed intrahepatic calcifications in 5 patients and choledochoscopy in 2 patients. Postoperative complications included 5 patients who devleoped abdominal abscesses. The operation time was (289.0±132.0) minutes. The intraoperative blood loss was (451.0±256.0) ml. The hospitalization after operation was (12.0±3.0) days. In 52 patients, 4 patients had residual stones and the residual rate was 7.7%. All of them were completely removed by T-tube sinus 8 weeks after operation.
Conclusions:Laparoscopic ultrasound helped to detect relevant bile ducts containing stones, reduced chance of bleeding in surgery, helped to clarify location and distribution of stones, improved accuracy of diagnosis, and reduced unnecessary hepatectomy by clearly defining intrahepatic bile duct stones intraoperatively. The residual intrahepatic and intrahepatic bile duct stones rates were reduced, and the safety and accuracy of the operations were improved.
