ABSTRACT
Objective To determine the methods and effects of common bile duct(CBD) exploration and primary suture by laparoscopic procedure after laparoscopic cholecystectomy (LC) . Methods After LC, 35 patients' CBD were explored.After hte CBD stone was removed by choledochofiberscopy completely and CBD stenosis was excluded, the CBD was sutured primarily. Results 32 cases of CBD gallstone were removed ,and 3 exploration were negative.All the 35 CBD were sutured primarily . Two patients occurred bile leakage 1～3 day after the operation ,which were cured by conservative therapy.29 patients were followed-up for 3～24 months,no residual stone or bile duct stricture was found. Conclusions Primary suture CBD is safe and effective in laparoscopic CBD exploration,if the patient selected correctly.
ABSTRACT
Objective To evaluate the value of bile duct drainage using ureter catheter through cystic duct remnant with primary closure of the common bile duct(CBD) incision after CBD exploration.Methods (Retrospective) analysis of the clinical data of 218 cases using this method. Results All cases were operated on successfully.There were no complications such as bile leakage,bile duct stricture in this series.The (catheter) were removed 5-7 days after operation in 215 cases,10 days after operation in 3.None of the 218 cases had complications after removal of the catheter.The rate of stone clearance was 99.7%(217/218).Average hospitalization time after operation was(6.5?3.0)days.All the 218 cases were followed up for 1-5 years.On ultrosounography no bile duct stricture was found in the followed up cases.Conclusions (Using) ureteral catheter through cystic duct remnant for drainage of bile duct after CBD exploration with primary closure of the CBD is an effctive,reliable and safe method in preventing postoperative bile leakage,bile duct stricture and diagnosis of the postoperative retention of bile duct stones.
ABSTRACT
Objective To study the practical clinical value of laparoscopic cholecystectomy(LC) combined with other laparoscopic surgery. Methods 206 patients treated by LC combined with other laparoscopic surgery were analysed retrospectively. Results Among the 206 cases of LC combined with other laparoscopic surgery, LC was combined with choledochal exploration in 64 patients, with appendectomy in 29 patients, with fenestration of hepatic cyst in 38 patients, with other hepatic operations in 13 patients, with unroofing of kidney cyst in 15 patients, with release of abdominal adhesions in 31 patients, and with other operative procedures in 16 patients. Laparoscopic operations were successful in 204 patients, and 2 patients were converted to laparotomy. Postoperative bile fistula occurred in 2 patients; 1 healed with conservative therapy, and 1 healed after reoperation. Conclusions Laparoscopic cholecystectomy combined with other laparoscopic surgery can adequately present the advantages of microsurgery by safe, effective and economical management of various abdominal diseases.