Objective To assess the clinical outcomes in patients who underwent laparoscopic primary closure of common bile duct (CBD) with or without transcystic cholangiography and transcystic biliary drainage.Methods From June 2013 to March 2016,we operated on 46 patients who underwent primary closure of common bile duct after laparoscopic choledochotomy (group A).The results were compared with 51 patients who underwent primary closure of common bile duct after laparoscopic choledochotomy together with transcystic biliary drainage (group B) during the same study period.Results There was a significant difference in the incidence of postoperative bile leakage between the two groups.The risk in group A was sig nificantly higher than group B (8.7％ vs 0％,P ＜0.05).The duration of operation in group A was significantly shorter than in group B [(125.3 ± 28.3) min vs (131.3 ± 20.5) min].There were no significant differences in the duration of hospital stay between the two groups [(7.3 ± 2.4) days vs (7.8 ± 1.9) days,P ＞ 0.05].All patients were followed up (range 3 months to 29 months,average 8.4 months).B-ultrasound examination showed no residual bile duct stones and the liver functions were normal.Conclusions Laparoscopic primary closure of common bile duct was possible after choledochotomy.Transcystic cholangiography and transcystic biliary drainage after primary closure of common bile duct were safer and more reli able.

Objective To evaluate bile duct drainage with ureteral catheter through cystic duct in laparoscopic common bile duct exploration followed by primary duct closure (LCBDEPDC) and posto laparoscopic endoscopic stone extraction treatment of extrahepatic bile duct stones.Methods The clinical data of 116 cases of extrahepatic bile duct stones were retrospectively analyzed.Patients were divided into 2 groups: 57 patients with dilated common bile duct were in group A treated with laparoscopic common bile duct exploration followed by primary duct closure and via cystic duct ureteral catheter biliary drainage.While in group B (59 patients) with normal calibre of the common bile duct, the procedures was laparoscopic cholecystectomy + via cystic duct ureteral catheter biliary drainage and postoperative endoscopic stone extraction.Results Procedures were successful in both the two groups.There was no postoperative pancreatitis and biliary leakage complications.The catheter was withdrawn in 6-9 d in group A postoperative hospitalization time was (8.5 ± 2) d.The catheter was withdrawn in 2-8 d in group B after endoscopic stone extraction.Postoperative hospitalization time was (7.6 ± 3) d.No complications occurred in both two groups relating extubation.Conclusions Bile duct drainage using the ureteral catheter via cyst duct after LCBDEPDC and endoscopic stone extraction treatment of extrahepatic bile duct stones effectively prevent postoperative pancreatitis, biliary leakage and bile duct stricture.

Objective To investigate the effectiveness and safety of the slender external biliary drainage tube (F5 ureter catheter) inserted into the common bile duct via the cystic duct in laparoscopic choledochotomy with primary closure.Methods Clinical data of 59 patients with cholecystolithiasis and choledocholithiasis treated in our hospital between Feburary 2013 and March 2016 were retrospectively analyzed.The patients were treated with laparoscopic common bile duct exploration followed by primary duct closure,and bile duct drainage with a slender catheter through cystic duct after closure of the choledochotomy.Results All the cases underwent surgery successfully.The postoperative output of bile drainage was 30-570 ml/d.There were no complications such as biliary leakage,cholangitis or biliary pancreatitis.The catheter was withdrawn in 6-8 d in 57 patients after the operation,and was withdrawn in 10-11 d in 2 patients after the operation.There was no discomfort after removing the catheter.Postoperative hospitalization time was (9.1 ± 2.0) d.All patients were followed up for 5 months to 3 years,with an average of 16 months.The B ultrasound examinations showed no residual bile duct stones and liver functions were normal.Conclusions External biliary drainage using a slender ureter catheter via the cystic duct is safe,effective and easy to perform.It may reduce postoperative potential complications,especially bile leakage.

In this paper the four indexes of two mussels-Mytilus edulis and Mytilus coruscus were measured. The four indexes were protein, amino acids,unsaturated fatty acids and inorganic elements. The contents of protein and crude fats in Mytilus coruscus were higher than those in Mytilus edulis. The contents of essential amino acids have no difference between the two mussels. Mytilus coruscus is a heavy seafood,as there are much more glutamic acid, glycine and aspartic acid in it. The content of docosahexenoic acid (DHA)in M. coruscus was much more than that of M. edulis. Except for Aluminium and Selenium,the other 12 kinds of elements in M. edulis were higher than those in M. coruscus. The contents of polyunsatu-rated fatty acids(PUFAs) were much more than those of monounsaturated acids (MUFAs)in M. coruscus. There is little difference of the content between PUFAs and MUFAs in M. edulis.

Objective To evaluate the value of bile duct drainage using ureter catheter through cystic duct remnant with primary closure of the common bile duct(CBD) incision after CBD exploration.Methods (Retrospective) analysis of the clinical data of 218 cases using this method. Results All cases were operated on successfully.There were no complications such as bile leakage,bile duct stricture in this series.The (catheter) were removed 5-7 days after operation in 215 cases,10 days after operation in 3.None of the 218 cases had complications after removal of the catheter.The rate of stone clearance was 99.7%(217/218).Average hospitalization time after operation was(6.5?3.0)days.All the 218 cases were followed up for 1-5 years.On ultrosounography no bile duct stricture was found in the followed up cases.Conclusions (Using) ureteral catheter through cystic duct remnant for drainage of bile duct after CBD exploration with primary closure of the CBD is an effctive,reliable and safe method in preventing postoperative bile leakage,bile duct stricture and diagnosis of the postoperative retention of bile duct stones.