Laparoscopy Combined with Choledochoscopy in Treatment of Schistosomiasis Liver Cirrhosis with Common Bile Duct Stone_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGJian-xin ,  JINWei-dong , CAIXun , ZHANGZhi-yong , YEJia-xin , MADan-dan

Department of General Surgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, Hubei Province, China;

Corresponding?author：

JINWei-dong, Email: mai_andy0@126.com

Keywords：

Common bile duct stone; Schistosomiasis liver cirrhosis; Minimally invasive treatment

DOI：

10.7507/1007-9424.20160348

Video：

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Objective To summarize experience of laparoscopy combined with choledochoscopy common bile duct exploration for patients with schistosomiasis liver cirrhosis with common bile duct stones. Method The clinical data of 45 patients with schistosomiasis liver cirrhosis combined with common bile duct stones (liver function Child-Pugh grade A and B) admitted in this hospital from September 2012 to September 2015 were analyzed retrospectively. Results Twenty cases were successfully treated by laparoscopy combined with choledochoscopy (laparoscope group), 25 cases were treated by conventional open common bile duct exploration (laparotomy group). Two cases were converted to laparotomy due to bleeding during laparoscopic operation. The mean operation time, intraoperative bleeding, postopera-tive hospitalization time, and postoperative total complications rate had no significant differences between these two groups (P>0.05). There were 2 cases of pulmonary infection and 1 case of incision infection in the laparoscope group, and 1 case of grade A bile leakage and 1 case of pulmonary infection in the laparotomy group, there was no common bile duct stone residual in these two groups. Conclusion Although laparoscopic surgery is more difficult for schistosomiasis liver cirrhosis combined with common bile duct stones patients, it is safe and feasible. Appropriate perioperative management and precise laparoscopic and choledochoscopic operation are key to success of operation.

Citation： ZHANGJian-xin, JINWei-dong, CAIXun, ZHANGZhi-yong, YEJia-xin, MADan-dan. Laparoscopy Combined with Choledochoscopy in Treatment of Schistosomiasis Liver Cirrhosis with Common Bile Duct Stone. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1362-1365. doi: 10.7507/1007-9424.20160348 Copy

1.	Silva MA, Wong T. Gallstones in chronic liver disease. J Gastroin-test Surg, 2005, 9(5):739-746.
2.	陳明, 鐘恩鵬. 肝硬化合并膽囊結石的外科治療. 中國普通外科雜志, 2015, 24(6):907-909.
3.	Butt Z, Hyder Q. Cholelithiasis in hepatic cirrhosis:evaluating the role of risk factors. J Pak Med Assoc, 2010, 60(8):641-644.
4.	張雪瑞,翟建. 血吸蟲病肝臟的影像學表現. 醫學綜述, 2009, 15(7):1094-1096.
5.	趙挺. 血吸蟲性肝硬化病人腹腔鏡膽囊切除術的特殊性. 浙江實用醫學, 2002, 7(5):267, 271.
6.	陳中, 倪家連, 劉魯岳, 等. 肝硬化門靜脈高壓癥合并膽石癥的處理分析. 中國普通外科雜志, 2011, 20(2):206-207.
7.	Paganini AM, Guerrieri M, Sarnari J, et al. Thirteen years, experience with laparoscopic transcystic common bile duct exploration for stones. Effectiveness and long-term results. Surg Endosc, 2007, 21(1):34-40.
8.	黃志強. 變幻世紀中的外科:挑戰與對策. 中華實驗外科雜志, 2007, 24(2):133-134.
9.	范瑞芳, 肖毅, 任彥順, 等. 腹腔鏡聯合膽道鏡微創治療老年人膽總管結石及膽囊結石的臨床研究. 西北國防醫學雜志, 2014, 35(5):416-419.
10.	游蓁, 葉輝, 熊先澤, 等. LC+LCBDE與ERCP/EST+LC治療膽囊結石合并膽總管結石的梗阻性黃疸患者的臨床對照研究. 中國普外基礎與臨床雜志, 2013, 220(11):1268-1271.
11.	Borzellino G, Rodella L, Saladino E, et al. Treatment for retained[corrected] common bile duct stones during laparoscopic cholecyste-ctomy:the rendezvous technique. Arch Surg, 2010, 145(12):1145-1149.
12.	Zang JF, Zhang C, Gao JY. Endoscopic retrograde cholangiopancre-atography and laparoscopic cholecystectomy during the same session:feasibility and safety. World J Gastroenterol, 2013, 19(36):6093-6097.
13.	菅志遠, 沈先鋒, 黃林生, 等. 三種微創方式治療膽囊結石合并膽總管結石的臨床療效分析. 中國普通外科雜志, 2015, 24(2):275-279.
14.	Ding G, Cai W, Qin M. Single-stage vs. two-stage management for concomitant gallstones and common bile duct stones:a prospective randomized trial with long-term follow-up. J Gastrointest Surg, 2014, 18(5):947-951.
15.	Kim KY, Han J, Kim HG, et al. Late complications and stone recurr-ence rates after bile duct stone removal by endoscopic sphinctero-tomy and large balloon dilation are similar to those after endoscopic sphincterotomy alone. Clin Endosc, 2013, 46(6):637-642.
16.	徐琳, 王峰, 張宇飛, 等. 內鏡下乳頭切開與開腹膽道探查治療膽總管結石合并肝硬化的療效比較. 外科理論與實踐, 2011, 16(6):587-588.
17.	Shelat VG, Chan CY, Liau KH, et al. Laparoscopic exploration can salvage failed endoscopic bile duct stone extraction. Singapore Med J, 2012, 53(5):313-317.
18.	Lee HM, Min SK, Lee HK. Long-term results of laparoscopic common bile duct exploration by choledochotomy for choledocholithiasis:15-year experience from a single center. Ann Surg Treat Res, 2014, 86(1):1-6.
19.	謝朝暉, 鐘勇. 腹腔鏡聯合纖維膽道鏡膽總管探查術的臨床應用. 西部醫學, 2012, 24(10):1894-1896.
20.	Sharma A, Dahiya P, Khullar R, et al. Management of common bile duct stones in the laparoscopic era. Indian J Surg, 2012, 74(3):264-269.
21.	Zhou Y, Wu XD, Fan RG, et al. Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg, 2014, 12(7):645-648.
22.	徐紅星, 徐海賓, 顧玉青, 等. 腹腔鏡膽總管探查術后一期縫合與T管引流的臨床研究. 中國普外基礎與臨床雜志, 2015, 22(10):1254-1256.
23.	魯珅, 許軍. 不同CO₂氣腹壓力對肝硬化病人肝功能影響的臨床觀察. 齊齊哈爾醫學院報, 2008, 29(3):279-281.

1. Silva MA, Wong T. Gallstones in chronic liver disease. J Gastroin-test Surg, 2005, 9(5):739-746.
2. 陳明, 鐘恩鵬. 肝硬化合并膽囊結石的外科治療. 中國普通外科雜志, 2015, 24(6):907-909.
3. Butt Z, Hyder Q. Cholelithiasis in hepatic cirrhosis:evaluating the role of risk factors. J Pak Med Assoc, 2010, 60(8):641-644.
4. 張雪瑞,翟建. 血吸蟲病肝臟的影像學表現. 醫學綜述, 2009, 15(7):1094-1096.
5. 趙挺. 血吸蟲性肝硬化病人腹腔鏡膽囊切除術的特殊性. 浙江實用醫學, 2002, 7(5):267, 271.
6. 陳中, 倪家連, 劉魯岳, 等. 肝硬化門靜脈高壓癥合并膽石癥的處理分析. 中國普通外科雜志, 2011, 20(2):206-207.
7. Paganini AM, Guerrieri M, Sarnari J, et al. Thirteen years, experience with laparoscopic transcystic common bile duct exploration for stones. Effectiveness and long-term results. Surg Endosc, 2007, 21(1):34-40.
8. 黃志強. 變幻世紀中的外科:挑戰與對策. 中華實驗外科雜志, 2007, 24(2):133-134.
9. 范瑞芳, 肖毅, 任彥順, 等. 腹腔鏡聯合膽道鏡微創治療老年人膽總管結石及膽囊結石的臨床研究. 西北國防醫學雜志, 2014, 35(5):416-419.
10. 游蓁, 葉輝, 熊先澤, 等. LC+LCBDE與ERCP/EST+LC治療膽囊結石合并膽總管結石的梗阻性黃疸患者的臨床對照研究. 中國普外基礎與臨床雜志, 2013, 220(11):1268-1271.
11. Borzellino G, Rodella L, Saladino E, et al. Treatment for retained[corrected] common bile duct stones during laparoscopic cholecyste-ctomy:the rendezvous technique. Arch Surg, 2010, 145(12):1145-1149.
12. Zang JF, Zhang C, Gao JY. Endoscopic retrograde cholangiopancre-atography and laparoscopic cholecystectomy during the same session:feasibility and safety. World J Gastroenterol, 2013, 19(36):6093-6097.
13. 菅志遠, 沈先鋒, 黃林生, 等. 三種微創方式治療膽囊結石合并膽總管結石的臨床療效分析. 中國普通外科雜志, 2015, 24(2):275-279.
14. Ding G, Cai W, Qin M. Single-stage vs. two-stage management for concomitant gallstones and common bile duct stones:a prospective randomized trial with long-term follow-up. J Gastrointest Surg, 2014, 18(5):947-951.
15. Kim KY, Han J, Kim HG, et al. Late complications and stone recurr-ence rates after bile duct stone removal by endoscopic sphinctero-tomy and large balloon dilation are similar to those after endoscopic sphincterotomy alone. Clin Endosc, 2013, 46(6):637-642.
16. 徐琳, 王峰, 張宇飛, 等. 內鏡下乳頭切開與開腹膽道探查治療膽總管結石合并肝硬化的療效比較. 外科理論與實踐, 2011, 16(6):587-588.
17. Shelat VG, Chan CY, Liau KH, et al. Laparoscopic exploration can salvage failed endoscopic bile duct stone extraction. Singapore Med J, 2012, 53(5):313-317.
18. Lee HM, Min SK, Lee HK. Long-term results of laparoscopic common bile duct exploration by choledochotomy for choledocholithiasis:15-year experience from a single center. Ann Surg Treat Res, 2014, 86(1):1-6.
19. 謝朝暉, 鐘勇. 腹腔鏡聯合纖維膽道鏡膽總管探查術的臨床應用. 西部醫學, 2012, 24(10):1894-1896.
20. Sharma A, Dahiya P, Khullar R, et al. Management of common bile duct stones in the laparoscopic era. Indian J Surg, 2012, 74(3):264-269.
21. Zhou Y, Wu XD, Fan RG, et al. Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg, 2014, 12(7):645-648.
22. 徐紅星, 徐海賓, 顧玉青, 等. 腹腔鏡膽總管探查術后一期縫合與T管引流的臨床研究. 中國普外基礎與臨床雜志, 2015, 22(10):1254-1256.
23. 魯珅, 許軍. 不同CO₂氣腹壓力對肝硬化病人肝功能影響的臨床觀察. 齊齊哈爾醫學院報, 2008, 29(3):279-281.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopy Combined with Choledochoscopy in Treatment of Schistosomiasis Liver Cirrhosis with Common Bile Duct Stone

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