Diagnostic and Laparoscopic Surgical Treatment of Calculus of Cystic Duct_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 JIANGPing , ZHENGXiang-yun , CHEHan-yang , LIUHai-bin

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China;

Corresponding?author：

JIANGPing, Email: jiangstjst@163.com

Keywords：

Laparoscopic cholecystectomy; Cystic duct; Calculus

DOI：

10.7507/1007-9424.20150124

Video：

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Objectives To investigate the diagnosis and laparoscopic surgical treatment methods of calculus of cystic duct. Methods The clinical data of 147 patients with calculus of cystic duct underwent laparoscopic cholecystectomy (LC) in the Second Affiliated Hospital of Wenzhou Medical College from June 2008 to June 2013 were analyzed retrospectively. Results Among the 147 patients with calculus of cystic duct, 19 cases were given preoperative diagnosis by B-ultrasound and CT scanning, 128 cases were found by exploration in operation; 146 cases underwent LC successfully and 1 case was converted to laparotomy.The 147 cases were followed-up for 3 months to 2 years with an average of 7 months and all cases were out of bile duct injury, hemorrhage, bile leakage, residual calculi or other complications. Conclusions Preoperative diagnosis of calculus of cystic duct is difficult, meanwhile, routine intraoperative probe is very necessary for the diagnosis of calculus of cystic duct.Proficiency in surgical technique with laparoscopic treatment of calculus of cystic duct is the key to the success of LC.

Citation： JIANGPing, ZHENGXiang-yun, CHEHan-yang, LIUHai-bin. Diagnostic and Laparoscopic Surgical Treatment of Calculus of Cystic Duct. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(4): 472-474. doi: 10.7507/1007-9424.20150124 Copy

1.	Reshetnyak VI.Concept of the pathogenesis and treatment of holelithiasis.World J Hepatol, 2012, 4(2):18-34.
2.	陳金明, 陳吉林, 毛澤軍.腹腔鏡膽囊切除術治療膽囊管結石92例.中國中西醫結合外科雜志, 2012, 18(4):409-410.
3.	Low SW, Iyer SG, Chang SK, et al.Laparoscopic cholecystectomy for acute cholecystitis:safe implementation of successful strategies to reduce conversion rates.Surg Endosc, 2009, 23(11):2424-2429.
4.	費維國, 姚坦.膽囊切除術后殘余膽囊結石例診治分析.中華普通外科雜志, 2009, 3(2):145-146.
5.	Mahmud S, Hamza Y, Nassar AH.The significance of cystic duct stones encountered during laparoscopic cholecystectomy.Surg Endosc, 2001, 15(5):460-462.
6.	Demetriades H, Pramateftakis MG, Kanellos I, et al.Retained gallbladder remnant after laparoscopic cholecystectomy.J Laparoendosc Adv Surg Tech A, 2008, 18(2):276-279.
7.	付振剛, 陳廣瑜, 成廣海, 等.困難腹腔鏡膽囊切除術的手術經驗(附128例報道).中國普外基礎與臨床雜志, 2014, 21(8):954-956.
8.	孫書祥.膽囊管結石術后的診治體會.臨床誤診誤治, 2007, 20(6):65.
9.	何海清, 伍華飛.腹腔鏡膽囊切除術及保膽取石術處理膽囊管結石的體會.腹腔鏡外科雜志, 2011, 16(10):779-780.
10.	Turner MA, Fulcher AS.The cystic duct:normal anatomy and disease processes.Radiographics, 2001, 21(1):3-22.
11.	Walsh RM, Ponsky JL, Dumot J.Retained gallbladder/cystic duct remnant calculi as a cause of postcholecystectomy pain.Surg Endosc, 2002, 16(6):981-984.
12.	裘法祖, 王建本, 張祐曾.腹部外科臨床解剖學.濟南:山東科學技術出版社, 2001:183-185.
13.	Laing FC, Jeffrey RB Jr.Choledocholithiasis and cystic duct obstruction:difficult ultrasonographic diagnosis.Radiology, 1983, 146(2):475-479.
14.	蔡華杰, 鄭志海, 周振旭, 等.膽囊管結石的診斷和腹腔鏡膽囊切除術中的處理策略.肝膽胰外科雜志, 2012, 24(6):481-483.
15.	張誠, 楊玉龍, 林美舉, 等.膽囊管結石的保膽手術策略.中國內鏡雜志, 2012, 18(10):1023-1027.
16.	Schmidt R, Tannheimer M, Danz B, et al.Clinical relevance of a routinely performed magnetic resonance cholangiopancreato-graphy (MRCP) prior to cholecystectomy.Zentralbl Chir, 2012, 137 (6):541-548.
17.	蔡茁, 黃志新, 婁安亭, 等.合并膽囊管結石的腹腔鏡膽囊切除術.肝膽外科雜志, 2013 21(1):51-53.
18.	呼勤.腹腔鏡膽囊管結石手術治療36例分析.大家健康:學術版, 2013, 7(11):146-147.
19.	Horwood J, Akbar F, Davis K, et al.Prospective evaluation of a selective approach to cholangiography for suspected common bile duct stones.Ann R Coll Surg Engl, 2010, 92(3):206.
20.	戚仁華, 楊正榮, 李建軍, 等.LC術中膽囊管結石的判斷與處理.安徽醫藥, 2013, 17(7):1187-1188.
21.	鄧天工, 牛秀莉, 姚婷, 等.膽囊管結石嵌頓合并膽囊管壞疽斷裂1例報告及文獻復習.中國微創外科雜志, 2014, 14(1):90-91.
22.	蘇旭, 李濱.腹腔鏡手術治療膽囊管結石31例臨床分析.肝膽胰外科雜志, 2011, 23(2):148-149.
23.	唐湘蓮, 蔣平, 李利義, 等.腹腔鏡手術治療膽囊管結石76例分析.中國實用外科雜志, 2009, 29(2):152-153.
24.	羅丁, 陳訓如, 毛靜熙, 等.腹腔鏡膽囊切除術中特殊類型膽囊管的處理.中華肝膽外科雜志, 2004, 10(2):103-104.
25.	湯慶峰, 戴德祥, 王紹勇.腹腔鏡手術治療嵌頓性膽囊結石的經驗.中國普外基礎與臨床雜志, 2006, 13(4):401-402.

1. Reshetnyak VI.Concept of the pathogenesis and treatment of holelithiasis.World J Hepatol, 2012, 4(2):18-34.
2. 陳金明, 陳吉林, 毛澤軍.腹腔鏡膽囊切除術治療膽囊管結石92例.中國中西醫結合外科雜志, 2012, 18(4):409-410.
3. Low SW, Iyer SG, Chang SK, et al.Laparoscopic cholecystectomy for acute cholecystitis:safe implementation of successful strategies to reduce conversion rates.Surg Endosc, 2009, 23(11):2424-2429.
4. 費維國, 姚坦.膽囊切除術后殘余膽囊結石例診治分析.中華普通外科雜志, 2009, 3(2):145-146.
5. Mahmud S, Hamza Y, Nassar AH.The significance of cystic duct stones encountered during laparoscopic cholecystectomy.Surg Endosc, 2001, 15(5):460-462.
6. Demetriades H, Pramateftakis MG, Kanellos I, et al.Retained gallbladder remnant after laparoscopic cholecystectomy.J Laparoendosc Adv Surg Tech A, 2008, 18(2):276-279.
7. 付振剛, 陳廣瑜, 成廣海, 等.困難腹腔鏡膽囊切除術的手術經驗(附128例報道).中國普外基礎與臨床雜志, 2014, 21(8):954-956.
8. 孫書祥.膽囊管結石術后的診治體會.臨床誤診誤治, 2007, 20(6):65.
9. 何海清, 伍華飛.腹腔鏡膽囊切除術及保膽取石術處理膽囊管結石的體會.腹腔鏡外科雜志, 2011, 16(10):779-780.
10. Turner MA, Fulcher AS.The cystic duct:normal anatomy and disease processes.Radiographics, 2001, 21(1):3-22.
11. Walsh RM, Ponsky JL, Dumot J.Retained gallbladder/cystic duct remnant calculi as a cause of postcholecystectomy pain.Surg Endosc, 2002, 16(6):981-984.
12. 裘法祖, 王建本, 張祐曾.腹部外科臨床解剖學.濟南:山東科學技術出版社, 2001:183-185.
13. Laing FC, Jeffrey RB Jr.Choledocholithiasis and cystic duct obstruction:difficult ultrasonographic diagnosis.Radiology, 1983, 146(2):475-479.
14. 蔡華杰, 鄭志海, 周振旭, 等.膽囊管結石的診斷和腹腔鏡膽囊切除術中的處理策略.肝膽胰外科雜志, 2012, 24(6):481-483.
15. 張誠, 楊玉龍, 林美舉, 等.膽囊管結石的保膽手術策略.中國內鏡雜志, 2012, 18(10):1023-1027.
16. Schmidt R, Tannheimer M, Danz B, et al.Clinical relevance of a routinely performed magnetic resonance cholangiopancreato-graphy (MRCP) prior to cholecystectomy.Zentralbl Chir, 2012, 137 (6):541-548.
17. 蔡茁, 黃志新, 婁安亭, 等.合并膽囊管結石的腹腔鏡膽囊切除術.肝膽外科雜志, 2013 21(1):51-53.
18. 呼勤.腹腔鏡膽囊管結石手術治療36例分析.大家健康:學術版, 2013, 7(11):146-147.
19. Horwood J, Akbar F, Davis K, et al.Prospective evaluation of a selective approach to cholangiography for suspected common bile duct stones.Ann R Coll Surg Engl, 2010, 92(3):206.
20. 戚仁華, 楊正榮, 李建軍, 等.LC術中膽囊管結石的判斷與處理.安徽醫藥, 2013, 17(7):1187-1188.
21. 鄧天工, 牛秀莉, 姚婷, 等.膽囊管結石嵌頓合并膽囊管壞疽斷裂1例報告及文獻復習.中國微創外科雜志, 2014, 14(1):90-91.
22. 蘇旭, 李濱.腹腔鏡手術治療膽囊管結石31例臨床分析.肝膽胰外科雜志, 2011, 23(2):148-149.
23. 唐湘蓮, 蔣平, 李利義, 等.腹腔鏡手術治療膽囊管結石76例分析.中國實用外科雜志, 2009, 29(2):152-153.
24. 羅丁, 陳訓如, 毛靜熙, 等.腹腔鏡膽囊切除術中特殊類型膽囊管的處理.中華肝膽外科雜志, 2004, 10(2):103-104.
25. 湯慶峰, 戴德祥, 王紹勇.腹腔鏡手術治療嵌頓性膽囊結石的經驗.中國普外基礎與臨床雜志, 2006, 13(4):401-402.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic and Laparoscopic Surgical Treatment of Calculus of Cystic Duct

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