ABSTRACT
Objective To discusses the clinical application value and safety of endoscopic minimally invasive cholecystolithotomy in gallstones treatment .Methods To retrospectively analyzes the clinical data of 94 patients with gallbladder stone from Feb .2010 to Feb .2013 ,and divided into endoscopic minimally invasive cholecystolithotomy (EMIC) group (46 cases) and laparoscopic chole-cystectomy (LC) group (48 cases) .Observed two groups of operation time ,intraoperative blood loss ,intraoperative bile duct inju-ry ,anal exhaust time ,postoperative hospitalization time ,bile reflux gastritis ,abdominal distention ,diarrhea ,common bile duct calculi and hospitalization expenses ,etc .Results Two groups of operation time ,hospitalization expenses ,length of hospital stay ,and intra-operative blood loss have no obvious difference(P>0 .05) ,in EMIC set ,the exhaust time ,postoperative bile duct calculi incidence , intraoperative bile duct injury ,bile reflux gastritis incidence and the incidence of abdominal distension ,diarrhea are significantly less than LC group (P<0 .05) .Conclusion The endoscopic minimally invasive cholecystolithotomy compared with laparoscopic chole-cystectomy had high security ,light pain ,quicker recovery ,less complications advantages .It has already achieved the purpose of min-imally invasive treatment ,while maintaining the integrity of bile duct and gallbladder function ,thus it is worthy of promoting .
ABSTRACT
Objective To discusses the feasibility of selective mini-cholecystolithotomy in treatment of gallstones .Methods To retrospectively analyzes the clinical data of the function good gallstones patients who treatmented by mini-cholecystolithotomy .Re-sults 4 cases treatmented by Laparoscopic cholecystectomy because of the severe cholecystitis ,1 case treatmented by laparoscopic cholecystectomy because of the severe adhesion around the gallbladder .51 cases treatmented by mini-cholecystolithotomy .In the fol-low-up of 1-3 years ,1 case of recurrence ,and the recurrence rate was 1 .96% .Conclusion The mini-cholecystolithotomy is a safe , effective ,feasible ,minimally invasive treatment method in treatmented gallstones ,but should be strictly grasp the surgical indica-tions .
ABSTRACT
Objective To investigate the clinical value of intraoperative cholangiography( IOC) by cystic duct during laparoscopic chol-ecystectomy( LC) . Methods The clinical data of 58 patients with LC received intraoperative cholangiography by cystic duct were analyzed retrospectively. Results In this group,Successful treatment of 55 cases(94. 83%),failed in 3 cases(5. 17%),no common bile duct calculi in 50 cases(90. 91%),small common bile duct calculi(0. 4 cm) in 5 cases(9. 09%). Among them 4 cases were received common bile duct exploration via laparotomy,1 case treated by laparoscopic transcystic biliary calculus extraction with Dormia basket. The cystic duct drained into the right hepatic duct in 1 patient. In all the cases,no bile duct injury,residual choledocholith,bile leakage,intra-abdominal infection and IOC related complications. Conclusion IOC during LC is simple and easy,with high success rate and good development effect,which can promptly discover the anatomical variations of biliary tract. It has important clinical application value to reduce biliary negative exploration,in-traoperative injury of biliary tract and postoperative common bile duct residual stone in basic hospital.