Journal of Laparoscopic Surgery. 2014, (06)

Clinical analysis of laparoscopy and choledochoscopy combined with electrohydraulic lithotripsy in the treatment of large common bile duct stonesChinese Full Text

WANG Yang;Department of Hepatobiliary Surgery,Central Hospital of Xianyang;

Abstract: Objective: To discuss the efficacy of laparoscopy and choledochoscopy combined with electrohydraulic lithotripsy in the treatment of large common bile duct stones. Methods: Retrospective analysis was made on the clinical data of 84 patients with obstructive jaundice and large common bile duct stones,who were treated by laparoscopy and choledochoscopy combined with electrohydraulic lithotripsy from Jan. 2005 to Nov. 2013. Results: Laparoscopy was successfully carried out in 80 cases,1 case was converted to open choledocholithotomy,hemostasis and T-tube drainage because of hemobilia. 1 case was converted to open exploration and pancreatoduodenectomy because of doubtful lower biliary tumor,cholangiocarcinoma was confirmed according to intraoperative frozen pathology; 1 case was confirmed lower papillary stenosis after transcystic duct calculi removal,endoscopic retrograde cholangiopancreatography and sphincterotomy was performed immediately and the bile flowed smoothly; and another case was converted to open choledocholithotomy and T-tube drainage because of close adhesion at Calot triangle caused by Mirizzi syndrome. There were no postoperative complications such as hemorrhage,bile leakage or common bile duct injury,postoperative hospital stay was 7-11 d. Conclusions: Laparoscopy and choledochoscopy combined with electrohydraulic lithotripsy in the treatment of large common bile duct stones is minimally invasive,safe and reliable,with high calculi removal rate and few complications. For patients with wide,short and straight cystic duct with large entrance,choledochoscope can be directly inserted to remove calculi with few trauma. The merits of this procedure are outstanding,which is worthy to be popularized.

Keywords：

Laparoscopy; Choledochoscopy; Electrohydraulic lithotripsy; Trans-cystic duct; Large common bile duct stones;

DOI：
10.13499/j.cnki.fqjwkzz.2014.06.454
Series：
Subject：
Classification Code：
R657.4

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Clinical analysis of laparoscopy and choledochoscopy combined with electrohydraulic lithotripsy in the treatment of large common bile duct stonesChinese Full Text

WANG Yang;Department of Hepatobiliary Surgery,Central Hospital of Xianyang;

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