Objective:To observe the surgical effects of laparoscopy and choledochoscope combination in the treatment of common bile duct stones and the complications occurrence situation,so as to provide reference for the clinical surgical treatment for common bile duct stones.Methods:The clinical materials of 120 common bile duct stones received surgical treatment in the Hepatobiliary Surgery of our hospital from January 2013 to January 2015 were retrospectively analyzed,and were divided into two groups according to the surgical approaches.The control group were given conventional open cholecystectomy,and the research group were given laparoscopy and choledochoscope combination surgery.The surgical situations and complications in these two groups were observed.Results:The surgical time in the research group was significantly longer than in the control group (P＜0.05),the blood loss,gastrointestinal recovery time,ambulation time,hospital stay were significantly shorter than in the control group (P＜0.05);the complication incidence such as pain,infection,bile leakage,residual stone in the research group was 8.3％,significantly lower than 21.7％ in the control group (P＜0.05).Conclusion:The combination treatment of laparoscopy and choledochoscope in the common bile duct stones has good curative effects,less blood loss,rapid recovery,and less impact on the gastrointestinal function,low incidence of complications,and can significantly shorten the length of hospital stay,can be used as the first choice in clinical practice.

Objective:To study the role of indocyanine green(ICG)fluorescence imaging in laparoscopic partial splenectomy (LPS).Methods:The data of 4 patients who underwent ICG fluorescence imaging technology for LPS at Beijing Luhe Hospital Affiliated to Capital Medical University from May 2017 to May 2020 were retrospectively analyzed. There were 3 females and 1 male, aged 46, 41, 27 and 12 years respectively. The extents of spleen preservation were compared between ICG fluorescence imaging with ordinary white light during operation. The residual splenic remnants were tested with fluorescence imaging after splenectomy, which showed fluorescence fading indicating good vascular perfusion.Results:ICG fluorescence imaging was performed on 4 patients. The operation time ranged from 180.0 to 250.0 min, and the intraoperative blood loss ranged from 40.0 to 200.0 ml. The postoperative hospital stay ranged from 4 to 14 days. There were no serious complications. Postoperative histopathology showed: splenic cyst ( n=1), splenic hemangioma ( n=2), and splenic laceration ( n=1). Conclusions:ICG fluorescence imaging technology had a significant role to play in partial splenectomy. This study showed this technique to improve safety of laparoscopic partial splenectomy.

Objective To investigate the diagnostic accuracies among laparoscopic ultrasonography (LUS),CT,MRCP and transabdominal ultrasonography in secondary choledocholithiasis,and to compare the procedural efficacy of LUS carried out by surgeons assisted by ultrasound physicians,and by surgeons alone.Methods Forty-two patients underwent laparoscopic transcystic common bile duct exploration (LTCBDE) in Beijing Luhe Hospital,Capital Medical University.All these patients underwent LUS examination.In 26 patients,LUS was carried out by surgeons alone while in 16 patients it was assisted by ultrasound physicians.The results of intraoperative choledochoscopy were used to verify the results in the two groups in scan time,and in its accuracies when compared with CT,MRCP and preoperative abdominal ultrasound.Results The accuracy of LUS was 92.9％,which was significantly better than that of CT (73.8％) and transabdominal ultrasonography (23.8％,P ＜0.05).It was also better than that of MRCP (89.7％),though the difference was not significant (P ＞ 0.05).Surgeons alone were faster than ultrasound physicians in performing LUS [(8.5 ± 3.0) min vs (13.2 ± 4.6) min,P ＜ 0.05].There were no statistically differences between the two groups in accuracy (92.3％ vs 93.8％,P ＞ 0.05).Conclusion LUS diagnosed common bile duct stones by surgeons who had adequate ultrasound training,with a high accuracy rate and good efficiency.