Volume 45 Issue 9
Sep.  2024
Turn off MathJax
Article Contents
Zhitang GUO, Kui LONG, Zhangbin CHEN, Weiran LIAO, Jiayun GE, Wei ZHANG. Clinical Analysis of Two Methods in the Treatment of Cholecystolithiasis Combined with Choledocholithiasis[J]. Journal of Kunming Medical University, 2024, 45(9): 144-150. doi: 10.12259/j.issn.2095-610X.S20240922
Citation: Zhitang GUO, Kui LONG, Zhangbin CHEN, Weiran LIAO, Jiayun GE, Wei ZHANG. Clinical Analysis of Two Methods in the Treatment of Cholecystolithiasis Combined with Choledocholithiasis[J]. Journal of Kunming Medical University, 2024, 45(9): 144-150. doi: 10.12259/j.issn.2095-610X.S20240922

Clinical Analysis of Two Methods in the Treatment of Cholecystolithiasis Combined with Choledocholithiasis

doi: 10.12259/j.issn.2095-610X.S20240922
  • Received Date: 2024-03-26
    Available Online: 2024-09-04
  • Publish Date: 2024-09-25
  •   Objective  To compare the clinical therapeutic effects of Laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration and primary suture (LBEPS) and LC + laparoscopic common bile duct exploration through cystic duct (LTCBDE).   Methods  The clinical data of 64 patients with cholecystolithiasis complicated with choledocholithiasis treated by LC + LBEPS and LC + LTCBDE from January 2018 to June 2023 were analyzed retrospectively, including 35 patients with LC + LBEPS and 29 patients with LC + LTCBDE. Besides, the operation time, intraoperative bleeding, abdominal drainage time, operation success rate, total hospitalization time, total hospitalization expenses, surgical complications and stone recurrence rate between the two groups were compared.   Results  There was no significant difference in baseline data, surgical success rate and postoperative complication rate between these two groups (P > 0.05). The operation time, blood loss, abdominal drainage time, total hospitalization time and total hospitalization cost in the LC + LBEPS group were significantly higher than those in LC + LTCBDE group (P < 0.05).   Conclusions  LC + LBEPS and LC + LTCBDE are two effective treatment methods for cholecystolithiasis complicated with choledocholithiasis without T tube. However, LC + LTCBDE has lower operation time, intraoperative bleeding, abdominal drainage time, total hospitalization time and total hospitalization cost, as well as better clinical treatment effect, so that it can be preferred on the premise of meeting surgical indications.
  • loading
  • [1]
    Lujian P,Xianneng C,Lei Z. Risk factors of stone recurrence after endoscopic retrograde cholangiopancreatography for common bile duct stones[J]. Medicine (Baltimore),2020,99(27):e20412.
    [2]
    Tian H L,Zhou J,Bai D S,et al. Comparison of repeated recurrence of common bile duct stones and occurrence of hepatolithiasis after synchronous laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration or with endoscopic sphincterotomy: A 10-year retrospective study[J]. J Gastrointest Surg,2023,27(6):1167-1176. doi: 10.1007/s11605-023-05645-5
    [3]
    Navaratne L, AI-Musawi J, Vutipongsatorn K, et al. Leveraging access to technology and enhanced surgical technique (LATEST) in laparoscopic bile duct exploration (LBDE)[J]. Surg Endosc,2023,37(3):2367-2378.
    [4]
    Bhardwaj A M,Trehan K K,Sharma V. Laparoscopic common bile duct exploration after failed endoscopic retrograde cholangio-pancreatography: Our patient series over a period of 10 years[J]. J Minim Access Surg,2022,18(4):533-538. doi: 10.4103/jmas.jmas_207_21
    [5]
    Shao M Y, Aburrous M, Huson D, et al. Development and validation of a hybrid simulator for ultrasound-guided laparoscopic common bile duct exploration[J]. Surg Endosc,2023,37(9):6943-6953.
    [6]
    Yin Y,He K,Xia X. Comparison of primary suture and t-tube drainage after laparoscopic common bile duct exploration combined with intraoperative choledochoscopy in the treatment of secondary common bile duct stones: A single-center retrospective analysis[J]. J Laparoendosc Adv Surg Tech A,2022,32(6):612-619. doi: 10.1089/lap.2021.0418
    [7]
    Deng Y,Tian H W,He L J,et al. Can t-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials[J]. Langenbecks Arch Surg,2020,405(8):1209-1217. doi: 10.1007/s00423-020-02000-z
    [8]
    段建文,袁磊,孙运鹏,等. 腹腔镜一步法与内镜联合腹腔镜两步法治疗80岁以上胆囊结石合并胆总管结石的疗效比较[J]. 中华肝胆外科杂志,2023,29(3):185-189.
    [9]
    李珂佳,刘昂,李炎阳,等. 同步三镜联合胆管一期缝合技术在胆囊结石合并扩张性胆总管结石患者中的应用[J]. 昆明医科大学学报,2022,43(7):134-139.
    [10]
    Pavlidis E T, Pavlidis T E. Current management of concomitant cholelithiasis and common bile duct stones[J]. World J Gastrointest Surg,2023,15(2):169-176.
    [11]
    郭志唐,魏东,李伟思,等. 全麻仰卧位下同步双镜联合在Ⅰ型Mirizzi综合征并胆总管结石手术中的应用价值[J]. 中华普通外科杂志,2020,35(9):681-684.
    [12]
    Lee S J,Choi I S,Moon J I,et al. Optimal treatment for concomitant gallbladder stones with common bile duct stones and predictors for recurrence of common bile duct stones[J]. Surg Endosc,2022,36(7):4748-4756. doi: 10.1007/s00464-021-08815-1
    [13]
    Pan L,Chen M,Ji L,et al. The safety and efficacy of laparoscopic common bile duct exploration combined with cholecystectomy for the management of cholecysto-choledocholithiasis: An up-to-date meta-analysis[J]. Ann Surg,2018,268(2):247-253. doi: 10.1097/SLA.0000000000002731
    [14]
    Huang X X,Wu J Y,Bai Y N,et al. Outcomes of laparoscopic bile duct exploration for choledocholithiasis with small common bile duct[J]. World J Clin Cases,2021,9(8):1803-1813. doi: 10.12998/wjcc.v9.i8.1803
    [15]
    Hori T. Comprehensive and innovative techniques for laparoscopic choledocholithotomy: A surgical guide to successfully accomplish this advanced manipulation[J]. World J Gastroenterol,2019,25(13):1531-1549 doi: 10.3748/wjg.v25.i13.1531
    [16]
    Huang J, Hu W, Liu J, et al. Laparoscopic transcystic common bile duct exploration: 8-year experience at a single institution[J]. J Gastrointest Surg,2023,27(3):555-564.
    [17]
    Wahi J E, Warmack T, Barghout R, et al. Five-year experience with transcystic laparoscopic common bile duct exploration[J]. J Laparoendosc Adv Surg Tech A,2023,33(3):276-280.
    [18]
    Fang L,Huang J,Zheng H,et al. Laparoscopic transcystic common bile duct exploration in patients with a nondilated common bile duct[J]. Ann Palliat Med,2021,10(12):12845-12856. doi: 10.21037/apm-21-3609
    [19]
    武亚东,汪栋,徐维宇,等. 日间手术与次日出院的腹腔镜经胆囊管胆道探查取石术回顾性病例对照研究[J]. 国际外科学杂志,2022,49(12):825-832.
    [20]
    张井虹,尚海涛,刘军舰,等. 腹腔镜胆总管一期缝合与内镜取石治疗继发性胆总管结石的临床疗效比较[J]. 中国普通外科杂志,2021,30(8):877-885.
    [21]
    刘楠, 刘奇, 陈德兴. 腹腔镜下经胆囊管切开胆总管探查取石术的研究进展[J]. 中国微创外科杂志(中英文),2024,24(5):363-368.
    [22]
    张志,李晓松,屠政斌,等. "隔膜"切开技术在腹腔镜经胆囊管胆总管探查术中的应用分析[J]. 中华肝胆外科杂志,2023,29(9):651-654.
    [23]
    曾明文,凌俊,万文武,等. 两种微创手术治疗胆囊结石合并胆总管结石的疗效比较[J]. 中国普通外科杂志,2022,31(2):160-167.
    [24]
    冯矗,罗浩,左亮,等. 腹腔镜胆囊切除联合胆道镜经胆囊管探查取石术与经胆总管取石术治疗胆囊合并胆总管结石的疗效比较[J]. 同济大学学报(医学版),2023,44(1):105-109
    [25]
    彭沙沙,裴斐. 腹腔镜胆囊管汇入部微切开胆总管探查取石一期缝合术的临床疗效[J]. 国际外科学杂志,2022,49(8):528-532.
  • Relative Articles

    [1] Quanchang ZHANG, Qiaolian WU, Yu LIU, Xin ZHAO. The Impact of Laparoscopic and Open Total Mesocolon Resection on Platelet Activation,Incidence of Complications,and Tumor Recurrence in Colon Cancer Patients. Journal of Kunming Medical University, 2023, 44(9): 104-109.  doi: 10.12259/j.issn.2095-610X.S20230919
    [2] Kejia LI, Ang LIU, Yanyang LI, Zhihong ZHANG, Guohui SHAO, Jiayun GE. Application of Syntaneous Trioscopy Combined with Bile Duct Suture Technique in Patients with Gallbladder Stones with Dilated Cholecholithiasis. Journal of Kunming Medical University, 2022, 43(7): 134-139.  doi: 10.12259/j.issn.2095-610X.S20220707
    [3] Zhong Shi Jie . Comparison of Three Treatment Methods for Cholecystolithiasis with Commom Bile Duct Stones. Journal of Kunming Medical University,
    [4] Luo Li Jun . . Journal of Kunming Medical University,
    [5] Zhang Yong . . Journal of Kunming Medical University,
    [6] He Hong Chun . . Journal of Kunming Medical University,
    [7] Luo Cong . . Journal of Kunming Medical University,
    [8] Li Juan . . Journal of Kunming Medical University,
    [9] Zhu En Pu . . Journal of Kunming Medical University,
    [10] Mu Bin . . Journal of Kunming Medical University,
    [11] Zhang Zhi Jun . . Journal of Kunming Medical University,
    [12] Xiao Zhong Xian . . Journal of Kunming Medical University,
    [13] Wang Ying . . Journal of Kunming Medical University,
    [14] Yang Bao Xiang . . Journal of Kunming Medical University,
    [15] Zhang Hai Jing . . Journal of Kunming Medical University,
    [16] Zhang Min . . Journal of Kunming Medical University,
    [17] Zhao Shu Hua . . Journal of Kunming Medical University,
    [18] . . Journal of Kunming Medical University,
    [19] . Transumbilical Single Incision Laparoscopic Cholecystectomy: a Report of 48 cases. Journal of Kunming Medical University,
    [20] . . Journal of Kunming Medical University,
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(3)

    Article Metrics

    Article views (342) PDF downloads(8) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return