Risk and Therapy Strategy of Tiny Gallbladder Stones During Laparoscopic Cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGWei ^1,2 , GONGRen-hua ¹ , LILei ² ,  CAOBao-qiang ¹

1. Department of General Surgery, Armed Police Anhui Corps Hospital, Hefei 230061, Anhui Province, China;
2. Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China;

Corresponding author：

CAOBao-qiang, Email: caobaoqiang@126.com

Keywords：

Laparoscopic cholecystectomy; Tiny gallbladder stone; Risk; Therapy strategy

DOI：

10.7517/1007-9424.20150255

Video：

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ObjectiveTo analyze risk and therapy strategy of tiny gallbladder stones during laparoscopic cholecystectomy (LC).MethodThe clinical data of 932 patients with tiny gallbladder stones performed LC from September 2013 to July 2014 were analyzed retrospectively.ResultsThe LC was successful in all the patients. The gallbladders were ruptured in 86 (9.23%) patients during operation. Following up 1-3 months, there were 26 patients with right upper abdominal pain and with residual small stones in the abdominal cavity, 57 patients without uncomfortable symptoms and without residual gallstone, 2 cases complicated with lesser abdominal abscess, 1 case complicated with incision infection. The incisional hernia and acute pancreatitis were not found.ConclusionsThe gallbladder with full of tiny stones performed LC easily leads to choledocholithiasis or acute pancreatitis. If intraoperative gallbladder rupture, the tiny stones might be residual in the peritoneal cavity and lead to abdominal infection or abscess, and incision infection or trocar site hernia. Specific operation could effectively avoid adverse complications.

Citation： WANGWei, GONGRen-hua, LILei, CAOBao-qiang. Risk and Therapy Strategy of Tiny Gallbladder Stones During Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 981-984. doi: 10.7517/1007-9424.20150255 Copy

1.	杨晓军, 高鹏, 司若湟, 等.常规/选择性胆道造影在腹腔镜胆囊切除术中的应用研究.中国普外基础与临床杂志, 2012, 19(10):1105-1109.
2.	De Carvalho LF, Fierens K, Kint M. Mini-laparoscopic versus conven-tional laparoscopic cholecystectomy:a randomized controlled trial. J Laparoendosc Adv Surg Tech A, 2013, 23(2):109-116.
3.	McDonald MP, Munson JL, Sanders L, et al. Consequences of lost gallstone. Surg Endosc, 1997, 11(7):774-777.
4.	Kurbanov FS, Alievlu G, Chinnikov MA, et al. Laparoscopic cholec-ystectomy in case of acute cholecystitis. Khirurqiia (Mosk), 2014, 5(2):16-18.
5.	Manukyan MN, Demirkalem P, Gulluoglu BM, et al. Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg, 2005, 189(4):451-452.
6.	Karsenti D. Endoscopic management of bile duct stones:residual bile duct stones after surgery, cholangitis, and "difficult stones". J Visc Surg, 2013, 151(3 Suppl):S39-S46.
7.	张淼, 张云, 鱼海峰, 等.胆管结石再手术治疗策略探讨.中国现代普通外科进展, 2012, 15(6):492-494.
8.	Shapey IM, Jaunoo SS, Arachchilage KM, et al. Biliary tract imaging for retained calculi after laparoscopic cholecystectomy:is risk stratification useful? Surg Laparosc Endosc Percutan Tech, 2012, 22(5):459-462.
9.	Qin M, Zou F, Zhao H, et al. Minimally invasive phasic treatment protocol for the treatment of extrahepatic bile duct stones. J Laparoendosc Adv Surg Tech A, 2012, 22(8):797-801.
10.	陶东升, 蒋结志, 叶临生, 等.腹腔镜胆囊切除联合术中胆道造影的应用.肝胆外科杂志, 2014, 22(6):462-463.
11.	李文.腹腔镜胆囊切除术中胆道造影负压抽吸取石术的应用.中国普通外科杂志, 2013, 22(8):1087-1089.
12.	孙振芝, 操海舟, 李少伟, 等.腹腔镜胆囊切除术中胆道造影的临床价值研究.中国医药导报, 2013, 10(36):55-57.
13.	熊仁海, 黄绪群, 吴琼, 等.腹腔镜胆囊切除术中胆囊破裂的临床分析(附305例报告).腹腔镜外科杂志, 2012, 17(8):592-594.
14.	Dobradin A, Jugmohan S, Dabul L. Gallstone-related abdominal abscess 8 years after laparoscopic cholecystectomy. JSLS, 2013, 17(1):139-142.
15.	钟先荣, 卢榜裕, 陈泽华, 等.腹腔镜胆囊切除术腹腔残留胆石对术后机体的影响.中国普外基础与临床杂志, 2010, 17(7):744-745.
16.	高允海, 冯雷, 韩柯鑫.急性胆囊炎腹腔镜切除术中胆囊破裂相关处理及预后分析.中国老年学杂志, 2014, 34(14):4051-4051.
17.	张勇, 陈卫, 王雪峰, 等.腹腔镜胆囊切除术中胆囊破裂的原因及其处理.上海第二医科大学学报, 2004, 24(8):674-675, 687.
18.	尚亚飞, 吕毅, 慕喜喜, 等.腹腔镜胆囊切除术后腹腔残留结石致成人脐尿管囊肿感染1例报告.中国实用外科杂志, 2014, 34(5):470-471.
19.	冉瑞图.关于胆囊切除术的几点意见.中国普外基础与临床杂志, 2008, 15(2):81-82.
20.	廖小凤.超声下胆道系统结石与气体的鉴别要点.中国医药指南, 2012, 10(9):512-513.
21.	Regoly MJ, Ihasz M. The sequelae of retained or lost stones:A complication of laparoscopic cholecystectomy. Surg Endosc, 2005, 9(8):931-932.
22.	陈明福.腹腔引流在腹腔镜胆囊切除术中的作用及指征.中国普通外科杂志, 2008, 17(6):623-624.
23.	朱维铭.腹部手术引流的正确置放和引流物判断.中国实用外科杂志, 2011, 31(1):66-68.
24.	孙枫林, 李晓军, 马杨, 等.胆囊微小结石与胆源性胰腺炎关系的回顾性分析.中国现代普通外科进展, 2010, 13(6):499-510.
25.	周霖.自制内镜推吸套管在治疗胆囊多发碎小结石、泥沙样结石中的应用.中国医药科学, 2012, 2(13):167, 169.

1. 杨晓军, 高鹏, 司若湟, 等.常规/选择性胆道造影在腹腔镜胆囊切除术中的应用研究.中国普外基础与临床杂志, 2012, 19(10):1105-1109.
2. De Carvalho LF, Fierens K, Kint M. Mini-laparoscopic versus conven-tional laparoscopic cholecystectomy:a randomized controlled trial. J Laparoendosc Adv Surg Tech A, 2013, 23(2):109-116.
3. McDonald MP, Munson JL, Sanders L, et al. Consequences of lost gallstone. Surg Endosc, 1997, 11(7):774-777.
4. Kurbanov FS, Alievlu G, Chinnikov MA, et al. Laparoscopic cholec-ystectomy in case of acute cholecystitis. Khirurqiia (Mosk), 2014, 5(2):16-18.
5. Manukyan MN, Demirkalem P, Gulluoglu BM, et al. Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg, 2005, 189(4):451-452.
6. Karsenti D. Endoscopic management of bile duct stones:residual bile duct stones after surgery, cholangitis, and "difficult stones". J Visc Surg, 2013, 151(3 Suppl):S39-S46.
7. 张淼, 张云, 鱼海峰, 等.胆管结石再手术治疗策略探讨.中国现代普通外科进展, 2012, 15(6):492-494.
8. Shapey IM, Jaunoo SS, Arachchilage KM, et al. Biliary tract imaging for retained calculi after laparoscopic cholecystectomy:is risk stratification useful? Surg Laparosc Endosc Percutan Tech, 2012, 22(5):459-462.
9. Qin M, Zou F, Zhao H, et al. Minimally invasive phasic treatment protocol for the treatment of extrahepatic bile duct stones. J Laparoendosc Adv Surg Tech A, 2012, 22(8):797-801.
10. 陶东升, 蒋结志, 叶临生, 等.腹腔镜胆囊切除联合术中胆道造影的应用.肝胆外科杂志, 2014, 22(6):462-463.
11. 李文.腹腔镜胆囊切除术中胆道造影负压抽吸取石术的应用.中国普通外科杂志, 2013, 22(8):1087-1089.
12. 孙振芝, 操海舟, 李少伟, 等.腹腔镜胆囊切除术中胆道造影的临床价值研究.中国医药导报, 2013, 10(36):55-57.
13. 熊仁海, 黄绪群, 吴琼, 等.腹腔镜胆囊切除术中胆囊破裂的临床分析(附305例报告).腹腔镜外科杂志, 2012, 17(8):592-594.
14. Dobradin A, Jugmohan S, Dabul L. Gallstone-related abdominal abscess 8 years after laparoscopic cholecystectomy. JSLS, 2013, 17(1):139-142.
15. 钟先荣, 卢榜裕, 陈泽华, 等.腹腔镜胆囊切除术腹腔残留胆石对术后机体的影响.中国普外基础与临床杂志, 2010, 17(7):744-745.
16. 高允海, 冯雷, 韩柯鑫.急性胆囊炎腹腔镜切除术中胆囊破裂相关处理及预后分析.中国老年学杂志, 2014, 34(14):4051-4051.
17. 张勇, 陈卫, 王雪峰, 等.腹腔镜胆囊切除术中胆囊破裂的原因及其处理.上海第二医科大学学报, 2004, 24(8):674-675, 687.
18. 尚亚飞, 吕毅, 慕喜喜, 等.腹腔镜胆囊切除术后腹腔残留结石致成人脐尿管囊肿感染1例报告.中国实用外科杂志, 2014, 34(5):470-471.
19. 冉瑞图.关于胆囊切除术的几点意见.中国普外基础与临床杂志, 2008, 15(2):81-82.
20. 廖小凤.超声下胆道系统结石与气体的鉴别要点.中国医药指南, 2012, 10(9):512-513.
21. Regoly MJ, Ihasz M. The sequelae of retained or lost stones:A complication of laparoscopic cholecystectomy. Surg Endosc, 2005, 9(8):931-932.
22. 陈明福.腹腔引流在腹腔镜胆囊切除术中的作用及指征.中国普通外科杂志, 2008, 17(6):623-624.
23. 朱维铭.腹部手术引流的正确置放和引流物判断.中国实用外科杂志, 2011, 31(1):66-68.
24. 孙枫林, 李晓军, 马杨, 等.胆囊微小结石与胆源性胰腺炎关系的回顾性分析.中国现代普通外科进展, 2010, 13(6):499-510.
25. 周霖.自制内镜推吸套管在治疗胆囊多发碎小结石、泥沙样结石中的应用.中国医药科学, 2012, 2(13):167, 169.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk and Therapy Strategy of Tiny Gallbladder Stones During Laparoscopic Cholecystectomy

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