Clinical strategy and individualized treatment of cholecystolithiasis / 国际外科学杂志

Gallstone is a common and frequently-occurring disease in surgery,and its formation is a process of many factors,many links and many steps,often accompanied by a variety of metabolic diseases.The treatment of cholecystolithiasis,operation time and operation mode are influenced by many factors.Clinicians are often confused because of their different strategies in diagnosis and treatment.Based on the domestic and foreign research progress of diagnosis and treatment of gallbladder calculi,combined with clinical practice,this article discusses the existing problems in the diagnosis and treatment of gallstone problems,treatment principles,individualized treatment strategy to make a discussion,aimed at strengthening grassroots doctors and general practitioners awareness of gallstones,individual treatment protocol.Therefore we could avoid excessive and inadequate treatment,and make the treatment of "standardization"" individualization",the benefit of the "maximum".

Role of Rouviere's sulcus in relation to posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy / 中华普通外科杂志

Objective To evaluate the function of Rouviere's sulcus with posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy.Methods The clinical data of 170 patients undergoing laparoscopic cholecystectomy through Rouviere's sulcus approach with posterior cystohepatic triangle from May 2016 to June 2017 in the Department of General Surgery,the Second People's Hospital of Wuhu were retrospectively analyzed.The incidences and types of Rouviere's sulcus were documented.Results The open type of Rouviere's sulcus was visualized in 108 patients(63.53％),the fused type in 44 patients(25.88％),and the deficient type in 18 patients (10.59％).Hence in a total of 152 (89.41％) patients had Rouviere's sulcus.All patients underwent laparoscopic cholecystectomy safely.There was no bile duct injury or mortality.Four patients (2.35％) were converted to open operation,all were deficient type of Rouviere's sulcus for chronic inflammation of the gallbladder triangle.Conclusion Rouviere's sulcus are present and visible in most patients.Guided by Rouviere's sulcus with posterior cystohepatic triangle it could be safely and effectively to expose the anatomical structure of Calot's triangle and prevent bile duct injury in laparoscopic cholecystectomy.