Transformation of main surgical hole during laparoscopic exploration of common bile duct / 中华全科医师杂志

ABSTRACT

During June 2012 to October 2014, a total of 48 patients with stones in common bile duct diagnosed by ultrasound and magnetic resonance cholangiopancreatography (MRCP) were randomly divided into two groups (n =24 each).The general group underwent conventional common bile duct exploration by laparoscopy (LCHTD) at left side.For improvement group, the operator timely transfered from left side to right side during laparoscopy.And two auxiliary holes of right side were used for suturing common bile duct.All patients successfully completed common bile duct exploration by laparoscopy.The suturing times of common bile duct were (13.6 ± 2.5) & (7.6 ± 2.7) min (t =11.365, P =0.000), intraoperative bleeding volume (77.52 ± 12.49) & (74.91 ± 13.66) ml (t =2.627,P =0.008), average peak temperature at day 3 post-operation (38.6 ± 0.5) & (37.4 ± 0.5) ℃ (t =9.954, P =0.000) and average postoperative hospitalization length (9.2 ± 3.4) & (7.1 ± 2.1) days (t =8.730, P =0.000).Compared with general group, the suturing time of common bile duct was significantly shorter in improvement group, the average highest temperature at day 3 post-operation were lower and complications (bile leakage, bile duct stricture & biliary tract bleeding) decreased significantly.The main hole conversion during common bile duct exploration by laparoscopy offers the advantages of flexibility, convenience and applicability.