Clinical analysis of combined antegrade and retrograde technique of laparoscopic cholecystectomy in prevention of bile duct injury / 中国普通外科杂志

ABSTRACT

Objective To discuss the clinical value of combined antegrade and retrograde technique of laparoscopic cholecystectomy in prevention of bile duct injury.Methods Clinical data of 613 patients who underwent laparoscopic cholecystectomy with combined antegrade and retrograde technique from March 1991 to June 2006 were analyzed retrospectively.Results Cholecystolithiasis with atrophy of gallbladder was found in 121 cases,acute and subacute cholecystitis in 432 cases,cholecystolithiasis with chronic cholecystitis in 42 cases and polyps of cholecyst in 18 cases.Nine cases were converted to laparotomy(5 cases of cholecystolithiasis with atrophy of gallbladder and 4 cases of subacute cholecystitis).The average operation time was 43.5 minutes.Bile leakage occured in only 1 case after operation and fully recovered after 3 days of drainage,and all the other cases had smooth recovery with no bile duct injuries or serious complications such as haemorrhage,infection or death.The mean hospitalization time after operation was 5.5 days.Conclusions The application of combined antegrade and retrograde technique can increase the success rate of laparoscopic cholecystectomy,and reduce the incidence of injuries of bile duct,especially in those patients with inadequate exposure or anatomical variation of Calot′s triangle.