Combination of Laparoscope, Choledochoscope, and Balloon Nasobiliary Exploration in Treatment of Cholecystolithiasis Combined with Choledocholithiasis with Small Diameter of Common Bile Duct (Report of 43 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENAn-ping , GAOYuan , LIHua-lin , HUTing , WANGJia-mu , ZHANGSheng-long , LIUJin-heng , SUOYun-sheng , LIUAn , YIBin

Department of Hepatobiliary Surgery, The Second Hospital of Chengdu City, Chengdu 610017, Sichuan Province, China;

Corresponding?author：

CHENAn-ping, Email: chenanping1954@163.com

Keywords：

Common bile duct diseases; Cholelithiasis; Laparoscopy; Choledochoscope; Nasobiliary

DOI：

10.7507/1007-9424.20160055

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize clinical experiences of combination of laparoscope,choledochoscope,and balloon nasobiliary exploration (LCBNE) in treatment of cholecystolithiasis combined with choledocholithiasis with small diameter (0.3-0.8 cm) of common bile duct (CBD). Methods From April 2010 to May 2015,there were 43 cases of cholecystolithiasis combined with choledocholithiasis with small diameter of CBD underwent LCBNE,involving choledochotomy,choledochoscopic exploration,electrohydralic lithothipsy,balloon nasobiliary dilatation for removing cholelith,nasobiliary drainage,and the primary closure of incision. Results The procedure was successful in 27 cases of removing the bile duct residual stones through the choledochoscopic procedure,9 cases through the balloon nasobiliary procedure,and 7 cases were converted to endoscopic sphincterotomy for choledocholithasis.No case was converted to open CBD exploration.No case had residual stone.Bile leakage occurred in 1 case,which was cured by peritoneal drainage and nasobiliary drainage.One patient had a slight pancreatitis after operation.One patient had the stenosis of primary suture of CBD incision.Total postoperative complications rate was 7.0%(3/43).No case had perforations of intestine and bile duct,bleeding,severe pancreatitis,and death after operation. Conclusion From preliminary results of limited cases in this study,if patients are indicated,combination of LCBNE in treatment of cholecystolithiasis combined with choledocholithiasis with small diameter of CBD is safe and effective.

Citation： CHENAn-ping, GAOYuan, LIHua-lin, HUTing, WANGJia-mu, ZHANGSheng-long, LIUJin-heng, SUOYun-sheng, LIUAn, YIBin. Combination of Laparoscope, Choledochoscope, and Balloon Nasobiliary Exploration in Treatment of Cholecystolithiasis Combined with Choledocholithiasis with Small Diameter of Common Bile Duct (Report of 43 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(2): 214-217. doi: 10.7507/1007-9424.20160055 Copy

1.	?吳孟超, 吳在德. 黃家駟外科學. 第7版. 北京:人民衛生出版社, 2008:1797.
2.	黃志強. 膽道外科基礎與臨床. 第2版. 北京:人民衛生出版社, 2003:3-7.
3.	李波, 陳安平, 索運生, 等. 腹腔鏡膽總管探查術中十二指腸鏡下乳頭狹窄切開術91例報道. 中華腔鏡外科雜志:電子版, 2010, 3(5):438-442.
4.	Topal B, Aerts R, Penninckx F. Laparoscopic common bile duct stone clearance with flexible choledochoscopy. Surg Endosc, 2007, 21(12):2317-2321.
5.	李波, 陳安平, 索運生, 等. 腹腔鏡膽總管探查即時縫合術983例報告. 中華腔鏡外科雜志:電子版, 2010, 3(5):411-415.
6.	Elgeidie AA, Elebidy GK, Naeem YM. Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones. Surg Endosc, 2011, 25(4):1230-1237.
7.	郭鑫, 陳安平, 李波, 等. 腹腔鏡、膽管鏡同期治療膽囊結石合并正常直徑膽總管結石. 中華普外科手術學雜志:電子版, 2012, 6(1):70-75.
8.	陳心煥, 許兆祥. 膽道探查一期縫合與T管引流的療效比較. 肝膽胰外科雜志, 2010, 22(4):327-330.
9.	王佳牧, 陳安平, 山長星, 等. 腹腔鏡膽總管探查術2 161例報告. 外科研究與新技術, 2013, 2(3):152-154, 166.
10.	Zhao LD, Bie P,Wang SG, et al. A randomized comparison of primary closure and T-tube drainage of the common bile duct after laparoscopic choledochotomy. Surg Endosc, 2008, 22(7):1595-1600.
11.	索運生, 陳安平, 肖宏, 等. 腹腔鏡下再次膽道手術83例報告. 中華普外科手術學雜志:電子版, 2012, 6(4):356-360.
12.	Zhu QD, Tao CL, Zhou MT, et al. Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis. Langenbecks Arch Surg, 2011, 396(1):53-62.
13.	李波, 陳安平, 索運生, 等. 腹腔鏡膽囊切除術術中聯合十二指腸鏡治療正常直徑膽總管結石158例. 中華腔鏡外科雜志:電子版, 2011, 4(1):36-40.
14.	張雷達, 別平, 陳平, 等. 腹腔鏡膽道探查術后膽管一期縫合與T管引流的療效比較. 中華外科雜志, 2004, 42(9):520-523.
15.	陳安平, 胡鋌, 李華林, 等. 同期腹腔鏡、膽管鏡、十二指腸鏡多入路治療膽囊結石合并細徑膽總管結石71例. 中國普外基礎與臨床雜志, 2014, 21(8):946-950.
16.	倪平志, 劉雋, 湯可立, 等. 膽總管探查術后一期縫合的臨床經驗及適應證探討. 中國普外基礎與臨床雜志, 2011, 18(3):320-323.
17.	索運生, 張明哲, 尹思能, 等. 腹腔鏡膽總管探查、一期縫合和T管引流后膽道壓力變化的比較. 中國微創外科雜志, 2006, 6(1):21-23.
18.	張啟瑜. 錢禮腹部外科學. 北京:人民衛生出版社, 2006:879.
19.	楊孫虎, 侯軍麗, 阿不都斯木, 等. 腹腔鏡治療膽囊結石合并肝外膽管結石臨床研究. 中國普外基礎與臨床雜志, 2014, 21(7):872-874.
20.	所廣軍, 徐安, 胡海. ERCP臨床應用指征探討. 中國普外基礎與臨床雜志, 2011, 18(5):533-536.
21.	王健, 杜波, 胡兵. EST后近期嚴重并發癥及其危險因素分析. 中國普外基礎與臨床雜志, 2010, 17(5):486-490.
22.	田大廣, 黃潔, 張捷, 等. LC與EST聯合應用治療膽囊結石繼發性膽總管結石. 中國普通外科雜志, 2006, 15(8):579-581.
23.	胡三元. 肝內、外膽管結石的腹腔鏡處理. 中國普外基礎與臨床雜志, 2008, 15(10):711-713.
24.	王佳牧, 陳安平, 山長星, 等. 腹腔鏡、膽道鏡、十二指腸鏡(三鏡)同期手術擴大一期縫合術應用199例報告. 外科研究與新技術, 2013, 2(3):170-172.
25.	郭鑫, 陳安平, 李波, 等. 腹腔鏡聯合十二指腸鏡早期治療輕型急性膽源性胰腺炎57例報告. 中華普外科手術學雜志:電子版, 2012, 6(2):196-201.
26.	李波, 陳安平, 索運生, 等. 腹腔鏡膽總管探查術1 712例. 中華腔鏡外科雜志:電子版, 2010, 3(4):343-346.

1. ?吳孟超, 吳在德. 黃家駟外科學. 第7版. 北京:人民衛生出版社, 2008:1797.
2. 黃志強. 膽道外科基礎與臨床. 第2版. 北京:人民衛生出版社, 2003:3-7.
3. 李波, 陳安平, 索運生, 等. 腹腔鏡膽總管探查術中十二指腸鏡下乳頭狹窄切開術91例報道. 中華腔鏡外科雜志:電子版, 2010, 3(5):438-442.
4. Topal B, Aerts R, Penninckx F. Laparoscopic common bile duct stone clearance with flexible choledochoscopy. Surg Endosc, 2007, 21(12):2317-2321.
5. 李波, 陳安平, 索運生, 等. 腹腔鏡膽總管探查即時縫合術983例報告. 中華腔鏡外科雜志:電子版, 2010, 3(5):411-415.
6. Elgeidie AA, Elebidy GK, Naeem YM. Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones. Surg Endosc, 2011, 25(4):1230-1237.
7. 郭鑫, 陳安平, 李波, 等. 腹腔鏡、膽管鏡同期治療膽囊結石合并正常直徑膽總管結石. 中華普外科手術學雜志:電子版, 2012, 6(1):70-75.
8. 陳心煥, 許兆祥. 膽道探查一期縫合與T管引流的療效比較. 肝膽胰外科雜志, 2010, 22(4):327-330.
9. 王佳牧, 陳安平, 山長星, 等. 腹腔鏡膽總管探查術2 161例報告. 外科研究與新技術, 2013, 2(3):152-154, 166.
10. Zhao LD, Bie P,Wang SG, et al. A randomized comparison of primary closure and T-tube drainage of the common bile duct after laparoscopic choledochotomy. Surg Endosc, 2008, 22(7):1595-1600.
11. 索運生, 陳安平, 肖宏, 等. 腹腔鏡下再次膽道手術83例報告. 中華普外科手術學雜志:電子版, 2012, 6(4):356-360.
12. Zhu QD, Tao CL, Zhou MT, et al. Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis. Langenbecks Arch Surg, 2011, 396(1):53-62.
13. 李波, 陳安平, 索運生, 等. 腹腔鏡膽囊切除術術中聯合十二指腸鏡治療正常直徑膽總管結石158例. 中華腔鏡外科雜志:電子版, 2011, 4(1):36-40.
14. 張雷達, 別平, 陳平, 等. 腹腔鏡膽道探查術后膽管一期縫合與T管引流的療效比較. 中華外科雜志, 2004, 42(9):520-523.
15. 陳安平, 胡鋌, 李華林, 等. 同期腹腔鏡、膽管鏡、十二指腸鏡多入路治療膽囊結石合并細徑膽總管結石71例. 中國普外基礎與臨床雜志, 2014, 21(8):946-950.
16. 倪平志, 劉雋, 湯可立, 等. 膽總管探查術后一期縫合的臨床經驗及適應證探討. 中國普外基礎與臨床雜志, 2011, 18(3):320-323.
17. 索運生, 張明哲, 尹思能, 等. 腹腔鏡膽總管探查、一期縫合和T管引流后膽道壓力變化的比較. 中國微創外科雜志, 2006, 6(1):21-23.
18. 張啟瑜. 錢禮腹部外科學. 北京:人民衛生出版社, 2006:879.
19. 楊孫虎, 侯軍麗, 阿不都斯木, 等. 腹腔鏡治療膽囊結石合并肝外膽管結石臨床研究. 中國普外基礎與臨床雜志, 2014, 21(7):872-874.
20. 所廣軍, 徐安, 胡海. ERCP臨床應用指征探討. 中國普外基礎與臨床雜志, 2011, 18(5):533-536.
21. 王健, 杜波, 胡兵. EST后近期嚴重并發癥及其危險因素分析. 中國普外基礎與臨床雜志, 2010, 17(5):486-490.
22. 田大廣, 黃潔, 張捷, 等. LC與EST聯合應用治療膽囊結石繼發性膽總管結石. 中國普通外科雜志, 2006, 15(8):579-581.
23. 胡三元. 肝內、外膽管結石的腹腔鏡處理. 中國普外基礎與臨床雜志, 2008, 15(10):711-713.
24. 王佳牧, 陳安平, 山長星, 等. 腹腔鏡、膽道鏡、十二指腸鏡(三鏡)同期手術擴大一期縫合術應用199例報告. 外科研究與新技術, 2013, 2(3):170-172.
25. 郭鑫, 陳安平, 李波, 等. 腹腔鏡聯合十二指腸鏡早期治療輕型急性膽源性胰腺炎57例報告. 中華普外科手術學雜志:電子版, 2012, 6(2):196-201.
26. 李波, 陳安平, 索運生, 等. 腹腔鏡膽總管探查術1 712例. 中華腔鏡外科雜志:電子版, 2010, 3(4):343-346.

Previous Article
主動脈瓣二尖瓣置換術同期右上肺葉切除術一例
Next Article
Experiences of Laparoscopic Extralevator Abdominoperineal Excision for 46 Cases of Advanced Low Rectal Cancer

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Combination of Laparoscope, Choledochoscope, and Balloon Nasobiliary Exploration in Treatment of Cholecystolithiasis Combined with Choledocholithiasis with Small Diameter of Common Bile Duct (Report of 43 Cases)

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content