Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZENGTian-cai ¹ , CHENXian-xiang ¹ , XUYang ² , CHENGCai-tao ¹ , FENGYong ¹ , ZHANGLin-fei ¹ , TUHua-hua ¹ ,  CAIQing-he ¹

1. Depment of Hepatobiliary Surgery, Affiliated People's Hospital, Hubei Medical College, Shiyan 442000, Hubei Province, China;
2. Infirmary of Hubei Medical College, Shiyan 442000, Hubei Province, China;

Corresponding?author：

CAIQing-he, Email: 504608008@qq.com

Keywords：

Extrahepatic bile duct stone; Laparoseopy; Common bile duct exploration; Stent drainage; T tube drainage

DOI：

10.7507/1007-9424.20140289

Video：

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Objective To investigate the efficacy and safety of laparoscopic cholecystectomy and common bile duct exploration(LCBDE) with biliary stent drainage or T tube drainage. Methods The clinical data of 68 cases of gallbladder and bile duct stones with the LCBDE by the same surgeon in our hospital from June 2008 to June 2013 were retrospectively analyzed. Twenty-two patients were treated with LCBDE and biliary stent drainage(stent drainage group), 46 patients were treated with LCBDE and T tube drainage(T tube drainage group). Results The operation were successfully completed of 2 groups. The anal exhaust time, peritoneal drainage time, postoperative hospitalization time, and hospital expenses in stent drainage group were shorter or less than thoes T tube drainage group(P < 0.05). There were no significant difference in the operative time, postoperative bilirubin level, and incidences of postoperative complications between the two groups(P > 0.05). Conclusions The stent drainage and T tube drainage after LCBDE has its own indications. Laparoscopic common bile duct exploration and biliary stent drainage is superior to the laparo-scopic common bile duct exploration and T tube drainage.

Citation： ZENGTian-cai, CHENXian-xiang, XUYang, CHENGCai-tao, FENGYong, ZHANGLin-fei, TUHua-hua, CAIQing-he. Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1203-1206. doi: 10.7507/1007-9424.20140289 Copy

1.	洪德飛, 彭淑牖.腹腔鏡肝膽胰脾外科手術操作與技巧[M].北京:人民衛生出版社, 2008:74.
2.	徐大華.微創外科時代的機遇、挑戰和思考[J].中華肝膽外科雜志, 2011, 17(8):603-605.
3.	蔡陽, 朱瑋, 封光華, 等. EST嚴重并發癥的外科治療[J].中華肝膽外科雜志, 2005, 11(9):616-617.
4.	張雷達, 王曙光, 別平, 等.不同方式的腹腔鏡膽道探查術治療膽總管結石的臨床前瞻性研究[J].中國內鏡雜志, 2006, 12(5):474-477.
5.	Costamagna G, Tringali A, Shah SK, et al. Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence[J]. Endoscopy, 2002, 34(4):273-279.
6.	劉衛懷, 李吉, 胡志霞, 等.腹腔鏡技術在肝外膽管結石治療中的應用分析[J].中華肝膽外科雜志, 2010, 16(6):473-474.
7.	楊春明.膽總管結石的治療選擇[J].中華普通外科雜志, 2010, 25(10):858-860.
8.	羅昆侖, 方征, 余鋒, 等.腹腔鏡經膽囊管開口微切開膽管并一期縫合膽管治療膽囊結石合并膽管結石[J].中華肝膽外科雜志, 2013, 19(5):349-351.
9.	戴途, 李建平, 陳波, 等.腹腔鏡聯合超細纖維膽道鏡治療膽總管結石[J].中華消化內鏡雜志, 2005, 22(5):334-335.
10.	錢禮, 鄭樹森, 張啟瑜, 等.錢禮腹部外科學[M].北京:人民衛生出版社, 2006:877.
11.	王俊, 孫權.膽總管探查后一期縫合并術中置膽道內支架引流術與T管引流術的比較[J].中國普通外科雜志, 2011, 20(8):85l-853.
12.	李凱旋, 廖永鋒, 吳紹全, 等.選擇性膽總管探查術一期縫合38例[J].實用醫學雜志, 2012, 28(4):680-681.
13.	Ambreen M, Shaikh AR, Jamal A, et al. Primary closure versus T-tube drainage after open choledochotomy[J]. Asian J Surg, 2009, 32(1):21-25.
14.	湯曉東, 劉雙海, 蔣劍, 等.不同方式腹腔鏡膽道探查術治療肝外膽管結石的臨床研究[J].中華肝膽外科雜, 2013, 19(8):589-592.
15.	沈漢斌, 鄭啟昌.腹腔鏡膽總管探查術后拔T管膽漏的防治[J].中國普通外科雜志, 2005, 14(9):715-716.
16.	李留崢, 羅開元, 冉江華.膽總管切開探查一期縫合膽管的臨床應用[J].肝膽外科雜志, 2005, 13(1):39-41.
17.	蔡珍福, 王堅, 周玉坤, 等.膽總管切開纖維膽道鏡探查一期縫合695例分析[J].肝膽胰外科雜志, 2004, 16(2):110-111.
18.	竇科峰, 李海民.肝膽管結石的綜合治療與個體化處理[J].中國實用外科雜志, 2004, 24(2):70-72.
19.	Krasinskas AM, Demetris AJ, Poterucha JJ, et al. The prevalence and natural history of untreated isolated central perivenulitis in adult allograft livers[J]. Liver Transpl, 2008, 14(5):625-632.
20.	巴明臣, 張紅衛, 陳訓如, 等.膽囊鏡膽囊切除術中放置腹腔引流管的臨床意義[J].肝膽胰外科雜志, 2000, 12(3):130-131, 136.
21.	趙樹龍, 林浩, 姜波健, 等.腹腔引流在膽囊切除術中的作用[J].肝膽胰外科雜志, 1999, 11(1):20.
22.	饒建華, 呂凌, 張峰, 等.腹腔引流術在肝臟切除術后應用的心要性探討[J].中華普通外科雜志, 2010, 25(4):303-305.
23.	Krasinskas AM, Ruchelli ED, Rand EB, et al. Central venulitis in pediatric liver allografts[J]. Hepatology, 2001, 33(5):1141-1147.
24.	Banff Working Group, Demetris AJ, Adeyi O, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction[J]. Hepatology, 2006, 44(2):489-501.
25.	趙志堅, 唐才喜, 馮斌, 等.快速康復外科理念指導下腹腔鏡膽道探查術的前瞻性隨機對照臨床研究[J].中國內鏡雜志, 2013, 19(6):575-580.
26.	陳迅, 唐才喜, 馮斌, 等.膽道術后快速康復中早期T管夾閉的臨床研究[J].醫學臨床研究, 2010, 27(9):1719-1721.
27.	伍曉汀, 周勇.腹腔引流管的正確選擇和合理應用[J], 中國實用外科雜志, 2005, 25(1):35-36.

1. 洪德飛, 彭淑牖.腹腔鏡肝膽胰脾外科手術操作與技巧[M].北京:人民衛生出版社, 2008:74.
2. 徐大華.微創外科時代的機遇、挑戰和思考[J].中華肝膽外科雜志, 2011, 17(8):603-605.
3. 蔡陽, 朱瑋, 封光華, 等. EST嚴重并發癥的外科治療[J].中華肝膽外科雜志, 2005, 11(9):616-617.
4. 張雷達, 王曙光, 別平, 等.不同方式的腹腔鏡膽道探查術治療膽總管結石的臨床前瞻性研究[J].中國內鏡雜志, 2006, 12(5):474-477.
5. Costamagna G, Tringali A, Shah SK, et al. Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence[J]. Endoscopy, 2002, 34(4):273-279.
6. 劉衛懷, 李吉, 胡志霞, 等.腹腔鏡技術在肝外膽管結石治療中的應用分析[J].中華肝膽外科雜志, 2010, 16(6):473-474.
7. 楊春明.膽總管結石的治療選擇[J].中華普通外科雜志, 2010, 25(10):858-860.
8. 羅昆侖, 方征, 余鋒, 等.腹腔鏡經膽囊管開口微切開膽管并一期縫合膽管治療膽囊結石合并膽管結石[J].中華肝膽外科雜志, 2013, 19(5):349-351.
9. 戴途, 李建平, 陳波, 等.腹腔鏡聯合超細纖維膽道鏡治療膽總管結石[J].中華消化內鏡雜志, 2005, 22(5):334-335.
10. 錢禮, 鄭樹森, 張啟瑜, 等.錢禮腹部外科學[M].北京:人民衛生出版社, 2006:877.
11. 王俊, 孫權.膽總管探查后一期縫合并術中置膽道內支架引流術與T管引流術的比較[J].中國普通外科雜志, 2011, 20(8):85l-853.
12. 李凱旋, 廖永鋒, 吳紹全, 等.選擇性膽總管探查術一期縫合38例[J].實用醫學雜志, 2012, 28(4):680-681.
13. Ambreen M, Shaikh AR, Jamal A, et al. Primary closure versus T-tube drainage after open choledochotomy[J]. Asian J Surg, 2009, 32(1):21-25.
14. 湯曉東, 劉雙海, 蔣劍, 等.不同方式腹腔鏡膽道探查術治療肝外膽管結石的臨床研究[J].中華肝膽外科雜, 2013, 19(8):589-592.
15. 沈漢斌, 鄭啟昌.腹腔鏡膽總管探查術后拔T管膽漏的防治[J].中國普通外科雜志, 2005, 14(9):715-716.
16. 李留崢, 羅開元, 冉江華.膽總管切開探查一期縫合膽管的臨床應用[J].肝膽外科雜志, 2005, 13(1):39-41.
17. 蔡珍福, 王堅, 周玉坤, 等.膽總管切開纖維膽道鏡探查一期縫合695例分析[J].肝膽胰外科雜志, 2004, 16(2):110-111.
18. 竇科峰, 李海民.肝膽管結石的綜合治療與個體化處理[J].中國實用外科雜志, 2004, 24(2):70-72.
19. Krasinskas AM, Demetris AJ, Poterucha JJ, et al. The prevalence and natural history of untreated isolated central perivenulitis in adult allograft livers[J]. Liver Transpl, 2008, 14(5):625-632.
20. 巴明臣, 張紅衛, 陳訓如, 等.膽囊鏡膽囊切除術中放置腹腔引流管的臨床意義[J].肝膽胰外科雜志, 2000, 12(3):130-131, 136.
21. 趙樹龍, 林浩, 姜波健, 等.腹腔引流在膽囊切除術中的作用[J].肝膽胰外科雜志, 1999, 11(1):20.
22. 饒建華, 呂凌, 張峰, 等.腹腔引流術在肝臟切除術后應用的心要性探討[J].中華普通外科雜志, 2010, 25(4):303-305.
23. Krasinskas AM, Ruchelli ED, Rand EB, et al. Central venulitis in pediatric liver allografts[J]. Hepatology, 2001, 33(5):1141-1147.
24. Banff Working Group, Demetris AJ, Adeyi O, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction[J]. Hepatology, 2006, 44(2):489-501.
25. 趙志堅, 唐才喜, 馮斌, 等.快速康復外科理念指導下腹腔鏡膽道探查術的前瞻性隨機對照臨床研究[J].中國內鏡雜志, 2013, 19(6):575-580.
26. 陳迅, 唐才喜, 馮斌, 等.膽道術后快速康復中早期T管夾閉的臨床研究[J].醫學臨床研究, 2010, 27(9):1719-1721.
27. 伍曉汀, 周勇.腹腔引流管的正確選擇和合理應用[J], 中國實用外科雜志, 2005, 25(1):35-36.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones

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