The best pathway in the laparoscopic surgery for choledocholithiasis according to the type of cystic duct undergoing MRCP / 中华消化内镜杂志

ABSTRACT

Objective To investigate the best pathway of laparoscopic surgery for choledocholithiasis. Methods According to MRCP,the cystic duct was divided into four types.The thick-straight type (n =89)and the thin-crooked type (n =65)patients randomly received the laparoscopic operations via the cystic duct or com-mon bile duct.The operation time,transit operation rate,complication rate and length of hospital stay after opera-tion were analysed.Results There were 46 cases of the thick-straight type via cystic duct,43 cases via common bile duct.The former had shorter operation time and hospital stay after operation (P <0.05),but there was no significant difference in transit operation rate and complication rate.There were 32 cases of the thin-crooked type via cystic duct and 33 cases via common bile duct and there were significant differences in the operation time, transit operation rate,complication rate and length of hospital stay after operation(P <0.05).Conclusion Ac-cording to different types,LCTBDE is suitable for the patients with thick-straight type,and LCHTD can be per-formed in thin-crooked type.Therefore,it can maximize the advantage of minimally invasive surgery.