We report a case of gallbladder stone receiving three-dimensional (3D) laparoscopic cholecystectomy, which allowed 3D visualization of the laparoscopic operative field and faithfully displayed the 3D anatomic structures of the abdominal organs and the gallbladder triangle. The operation was successfully completed in 32 min without intraoperative complications. 3D laparoscopic surgery allows more precise operation with reduced complications and helps to shorten the operative time, and is suitable for more complex laparoscopic surgery.
Abdominal Cavity ; Cholecystectomy, Laparoscopic ; Cholelithiasis ; surgery ; Gallstones ; Humans ; Intraoperative Complications

Adult ; Cholecystectomy, Laparoscopic ; methods ; Cholecystitis ; complications ; surgery ; Female ; Gallstones ; complications ; surgery ; Humans ; Treatment Outcome

Congenital pulmonary hypoplasia is a rare developmental abnormality of the lung with an incidence rate of around 1/5000 000. As a fatal condition associated with respiratory insufficiency after birth, this disease is rare in adults. We treated a 29-year-old female patient with congenital pulmonary hypoplasia and concurrent of cystic duct calculus in May, 2011 using single-port transumbilical laparoscopic cholecystectomy, which resulted in a good therapeutic effect comparable to that by routine laparoscopic cholecystectomy.
Abnormalities, Multiple ; Adult ; Cholecystectomy, Laparoscopic ; methods ; Female ; Gallstones ; complications ; surgery ; Humans ; Lung ; abnormalities ; Lung Diseases ; complications

OBJECTIVETo assess the feasibility and safety of laparoscopic anatomical hepatectomies (LAH) for intrahepatic bile duct stone.

METHODSLAH was performed in 14 patients with intrahepatic bile duct stone, while another 20 patients with intrahepatic bile duct stone underwent classical operation. Surgical time, blood loss, postoperative complications, and postoperative hospital stay were recorded.

RESULTSThe operations were successful in all 14 patients who underwent LAH. Surgical time was 190-420 mm [mean (259 +/- 134) mm]. Blood loss during operation was 220-1 000 ml [mean (454.5 +/- 314.2) ml]. No serious postoperative complications occurred. All these 14 patients were discharged with T dragin 7-14 days later, and the mean postoperative hospital stay was (9.2 +/- 3.4) days. In the classical operation group, the surgical time was 125-257 mm [mean (178 +/- 58) mm] and the blood loss was 210-1200 ml [mean (550.9 +/- 348.1) ml] All the patients were discharged with T dragin 9-25 days after operation, and the mean postoperative hospital stay was (13.4 +/- 4.7) days. Surgical time of LAH was longer than classical operation (P < 0.05). Rate of postoperative complications and postoperative hospital stay were decreased in LAH (P < 0.05, P < 0.01). The difference of blood loss during operation was no significance between LAH and classical operation (P > 0.05).

CONCLUSIONSLAH is feasible and safe for selected patients with intrahepatic bile duct stones. As a minimally invasive procedure, it can reduce surgical time, blood loss, hospital stay, and postoperative complications.

Gallstones ; complications ; surgery ; Hepatectomy ; instrumentation ; Humans ; Laparoscopy ; Length of Stay ; Postoperative Complications ; etiology ; Time Factors ; Treatment Outcome

OBJECTIVETo evaluate the safety and efficacy between endoscopic papillary balloon dilatation (EPBD) and endoscopic sphincteropapillotomy ( EST) for common bile duct stones using meta-analysis method.

METHODSRandomizd controlled trials comparing EPBD with EST for common bile duct stones and published from January 1990 to July 2012 were recruited. This meta-analysis was conducted to estimate short-term and long-term complications. Fixed random effect model or random effect model was established to analyze the data.

RESULTSTwelve randomizd controlled trials were included in this analysis. These studies included 1865 patients, 925 of them were treated with EPBD and 940 were treated with EST. The analysis of basic characteristics of these included studies showed that: compared to EST, patients in the EPBD group were younger (OR = -1.16, 95% CI: -1.49 to -0.84, P = 0.00), while in two groups, there were no significant difference (P > 0.05) in gender proportion, average size of stones, number of gallstones, previous cholecystectomy, the number of merged duodenal diverticulum, common bile duct diameter, the total follow-up time. Also, compared to EST, the overall stone clearance in the EPBD group was lower (OR = 0.64, 95% CI: 0.42 to 0.96, P = 0.03), pancreatitis incidence was higher (OR = 2.67, 95% CI: 1.61 to 4.43, P = 0.00), incidence of bleeding (OR = 0.12, 95% CI: 0.04 to 0.34, P = 0.00), acute cholecystitis (OR= 0.39, 95% CI: 0.18 to 0.84, P = 0.02), total long-term complication rate (OR = 0.53, 95% CI: 0.36 to 0.77, P = 0.01), stone recurrence rate more than a year were lower (OR= 0.48, 95% CI: 0.26 to 0.90, P = 0.02). While in two groups, there were no significant difference (P > 0.05) in the stone removal on 1 '' attempt, the total near-term complications and acute cholangitis.

CONCLUSIONSOn the basis of lower rates of bleeding, EPBD seems to be preferred strategy over EST for endoscopic remove of common bile duct stones in patients who have coagulopathy. Although stone recurrence rate more than a year of EPBD is lower, but the overall stone clearance rate is lower and the risk of pancreatitis is higher than that of EST.

Dilatation ; Gallstones ; surgery ; Humans ; Postoperative Complications ; epidemiology ; Randomized Controlled Trials as Topic ; Sphincterotomy, Endoscopic ; Treatment Outcome

OBJECTIVETo explore clinical features, diagnostic methods and treatment of gallstone ileus.

METHODSClinical data of 5 patients with gallstone ileus were analyzed retrospectively. Pertinent literature from China between 2000 and 2009 were reviewed. The disease onset, clinical manifestations, imaging characteristics, diagnosis and treatment of gallstone ileus were studied.

RESULTSFour out of 5 patients were female aged over 60, of whom 3 had a previous history of cholelithiasis, 2 had a history of cholangiojejunostomy internal drainage procedure. Four patients underwent enterotomy and gallstone extraction combined with hepatobiliary operation, while one underwent enterotomy alone. There was no postoperative recurrence. A review of the literature from China revealed 441 cases with intestinal obstruction caused by gallstone, consisting 1.15% of all the cases with bowel obstruction. 67.12% were female. 73.56% were elderly. 87.92% were from cystoenteral fistula. Site of bowel obstruction in ileum was 64.17% of the cases. 71.89% were misdiagnosed with other types of obstruction. Two hundred twenty-five patients underwent enterotomy and gallstone extraction combined with hepatobiliary operation, which carried a lower rate of postoperative recurrence and malignancy (P<0.05) than enterotomy alone. There were no statistical significant differences in the occurrence of postoperative cystoenteral fistula, wound infection, pulmonary infection, cure rate, and mortality(P>0.05).

CONCLUSIONSThe incidence of gallstone ileus is low and more common in female elderly. The gallstones often drain through cystoenteral fistula and lodge in the ileum. Enterotomy without hepatobiliary operation is associated with potential risk of recurrence and development of gallbladder malignancy. Combined hepatobiliary operation is recommended in patients without significant comorbidities.

Aged ; Female ; Gallstones ; complications ; diagnosis ; surgery ; Humans ; Intestinal Obstruction ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Retrospective Studies

Echinococcal disease can develop anywhere in the human body. The liver represents its most frequent location. Hepatic hydatid cysts may rupture into the biliary tract, thorax, peritoneum, viscera, digestive tract or skin. We report a rare case with rupture of the right hepatic duct into a hydatid cyst in a woman with known hydatid disease and choledocholithiasis. The increased intra-luminal pressure in the biliary tree caused the rupture into the adjacent hydatid cyst. The creation of the fistula between the right hepatic duct and the hydatid cyst decompressed the biliary tree, decreased the bilirubin levels and offered a temporary resolution of the obstructive jaundice. Rupture of a hydatid cyst into the biliary tree usually leads to biliary colic, cholangitis and jaundice. However, in case of obstructive jaundice due to choledocholithiasis, it is possible that the cyst may rupture by other way around while offering the patient a temporary relief from his symptoms.
Bilirubin/blood ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy ; Choledocholithiasis/complications/diagnosis ; Common Bile Duct/surgery ; Echinococcosis, Hepatic/complications/*diagnosis/surgery ; Female ; Gallstones/complications/diagnosis ; Hepatic Duct, Common/*surgery ; Humans ; Jaundice, Obstructive/complications/diagnosis ; Middle Aged ; Rupture ; Tomography, X-Ray Computed

Acute pancreatitis and afferent loop syndrome (ALS) have similar symptoms and physical findings. Accurate early diagnosis is essential, as the management of acute pancreatitis is predominantly conservative whereas ALS usually requires surgery. We experienced one case of pancreatitis due to ALS with internal hernia. Laboratory findings of patient showed elevated serum amylase, lipase and WBC count. One day after admission, diagnosis was modified as acute pancreatitis caused by ALS on computed tomography. Patient was managed with surgical treatment and operation finding revealed ALS due to internal hernia. He was recovered well after surgical treatment and discharged without significant sequelae.
Acute Disease ; Afferent Loop Syndrome/complications/*diagnosis/surgery ; Endoscopy, Gastrointestinal ; Gallstones ; Hernia, Abdominal/*complications ; Humans ; Male ; Middle Aged ; Pancreatitis/*diagnosis/etiology ; Radiography, Abdominal ; Tomography, X-Ray Computed

The use of non-absorbable suture materials for cystic duct ligation after cholecystectomy can expose patients to the risk of recurrent stone formation in the common bile duct (CBD). However, in Korea suture materials have rarely been found to act as a nidus for common bile duct calculus formation. Recently, we experienced a case in which suture material, that had migrated from a previous cholecystectomy site into the CBD, probably served as a nidus for common bile duct stone formation. The stone was confirmed by endoscopic retrograde cholangiopancreatography (ERCP) and removed successfully using a basket. The authors report a case of surgical suture migration and discuss its subsequent role as a stone forming nucleus within the CBD in a patient who underwent open cholecystectomy; and include a review of the literature.
Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy/*adverse effects ; Foreign Bodies/*complications ; Foreign-Body Migration/*complications ; Gallstones/*etiology/surgery ; Humans ; Male ; Risk Factors ; Surgical Instruments ; Sutures/*adverse effects

No abstract available.
Aged, 80 and over ; Cholangiopancreatography, Endoscopic Retrograde/*methods ; Female ; Gallstones/*complications/diagnosis/radiography/surgery ; Humans ; Situs Inversus/*complications/radiography ; Tomography, X-Ray Computed