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.
ABSTRACT
Objective To establish an animal model with installation of gastrobiliary duct drainage (GBDD) in the primary suture after exploration of common bile duct, to assess the safety and feasibility of GBDD. Methods Thirty dogs were randomly divided into three groups: control group (n=5), primary suture group (n= 10) and GBDD group (n= 15). Serum TBil levels, bile leakage,and complications were observed and compared. Results No increase in serum TBil level was observed in the control group. However, serum TBil levels were significantly increased in the primary suture group compared to the GBDD group (P＜0. 01). GBDD were all successfully withdrawn at mean (7. 0±1.7) days after the operation. No bile leakage was found in the GBDD group, which was significantly different compared to 5/10 bile leakage cases in primary suture group (P＜0. 05). There were 3/10 cases of bile peritonitis, infection of incisional wound and splitted in the primary suture group, while there were no such complications in the GBDD group (all P＞0.05). Conclusions GBDD is safe and feasible. It can shorten biliary drainage time and prevent occurrence of bile leakage.Therefore, it has unique value in clinical application.
ABSTRACT
Objective To review our experience in treatment of liver hydatid diease.Methods The data of 819 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively.Exploration of common bile duct was done in 172 cases.There were men 95 and women 77with a mean age of 31.5±0.5 years.In addition to treatment of the cyst cavity,patients was divided into two groups.The patients in group A received cholangiography and exploration of common bile duct through cystic duct while those in group B underwent cholangiography and common bile duct ex-pioration through T tube.Results The length of hospital stay and cavity-related problems for both groups had no significant difference.Biliary tract-related problems in two groups had significant differ-ence.Conclusion Cholangiography and common bile duct exploration through cystic duct can com-pletely solve the cavity-related problems while avoiding T-tube related problems.