Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZENGTian-cai ¹ , CHENXian-xiang ¹ , XUYang ² , CHENGCai-tao ¹ , FENGYong ¹ , ZHANGLin-fei ¹ , TUHua-hua ¹ ,  CAIQing-he ¹

1. Depment of Hepatobiliary Surgery, Affiliated People's Hospital, Hubei Medical College, Shiyan 442000, Hubei Province, China;
2. Infirmary of Hubei Medical College, Shiyan 442000, Hubei Province, China;

Corresponding author：

CAIQing-he, Email: 504608008@qq.com

Keywords：

Extrahepatic bile duct stone; Laparoseopy; Common bile duct exploration; Stent drainage; T tube drainage

DOI：

10.7507/1007-9424.20140289

Video：

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Objective To investigate the efficacy and safety of laparoscopic cholecystectomy and common bile duct exploration(LCBDE) with biliary stent drainage or T tube drainage. Methods The clinical data of 68 cases of gallbladder and bile duct stones with the LCBDE by the same surgeon in our hospital from June 2008 to June 2013 were retrospectively analyzed. Twenty-two patients were treated with LCBDE and biliary stent drainage(stent drainage group), 46 patients were treated with LCBDE and T tube drainage(T tube drainage group). Results The operation were successfully completed of 2 groups. The anal exhaust time, peritoneal drainage time, postoperative hospitalization time, and hospital expenses in stent drainage group were shorter or less than thoes T tube drainage group(P < 0.05). There were no significant difference in the operative time, postoperative bilirubin level, and incidences of postoperative complications between the two groups(P > 0.05). Conclusions The stent drainage and T tube drainage after LCBDE has its own indications. Laparoscopic common bile duct exploration and biliary stent drainage is superior to the laparo-scopic common bile duct exploration and T tube drainage.

Citation： ZENGTian-cai, CHENXian-xiang, XUYang, CHENGCai-tao, FENGYong, ZHANGLin-fei, TUHua-hua, CAIQing-he. Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1203-1206. doi: 10.7507/1007-9424.20140289 Copy

1.	洪德飞, 彭淑牖.腹腔镜肝胆胰脾外科手术操作与技巧[M].北京:人民卫生出版社, 2008:74.
2.	徐大华.微创外科时代的机遇、挑战和思考[J].中华肝胆外科杂志, 2011, 17(8):603-605.
3.	蔡阳, 朱玮, 封光华, 等. EST严重并发症的外科治疗[J].中华肝胆外科杂志, 2005, 11(9):616-617.
4.	张雷达, 王曙光, 别平, 等.不同方式的腹腔镜胆道探查术治疗胆总管结石的临床前瞻性研究[J].中国内镜杂志, 2006, 12(5):474-477.
5.	Costamagna G, Tringali A, Shah SK, et al. Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence[J]. Endoscopy, 2002, 34(4):273-279.
6.	刘卫怀, 李吉, 胡志霞, 等.腹腔镜技术在肝外胆管结石治疗中的应用分析[J].中华肝胆外科杂志, 2010, 16(6):473-474.
7.	杨春明.胆总管结石的治疗选择[J].中华普通外科杂志, 2010, 25(10):858-860.
8.	罗昆仑, 方征, 余锋, 等.腹腔镜经胆囊管开口微切开胆管并一期缝合胆管治疗胆囊结石合并胆管结石[J].中华肝胆外科杂志, 2013, 19(5):349-351.
9.	戴途, 李建平, 陈波, 等.腹腔镜联合超细纤维胆道镜治疗胆总管结石[J].中华消化内镜杂志, 2005, 22(5):334-335.
10.	钱礼, 郑树森, 张启瑜, 等.钱礼腹部外科学[M].北京:人民卫生出版社, 2006:877.
11.	王俊, 孙权.胆总管探查后一期缝合并术中置胆道内支架引流术与T管引流术的比较[J].中国普通外科杂志, 2011, 20(8):85l-853.
12.	李凯旋, 廖永锋, 吴绍全, 等.选择性胆总管探查术一期缝合38例[J].实用医学杂志, 2012, 28(4):680-681.
13.	Ambreen M, Shaikh AR, Jamal A, et al. Primary closure versus T-tube drainage after open choledochotomy[J]. Asian J Surg, 2009, 32(1):21-25.
14.	汤晓东, 刘双海, 蒋剑, 等.不同方式腹腔镜胆道探查术治疗肝外胆管结石的临床研究[J].中华肝胆外科杂, 2013, 19(8):589-592.
15.	沈汉斌, 郑启昌.腹腔镜胆总管探查术后拔T管胆漏的防治[J].中国普通外科杂志, 2005, 14(9):715-716.
16.	李留峥, 罗开元, 冉江华.胆总管切开探查一期缝合胆管的临床应用[J].肝胆外科杂志, 2005, 13(1):39-41.
17.	蔡珍福, 王坚, 周玉坤, 等.胆总管切开纤维胆道镜探查一期缝合695例分析[J].肝胆胰外科杂志, 2004, 16(2):110-111.
18.	窦科峰, 李海民.肝胆管结石的综合治疗与个体化处理[J].中国实用外科杂志, 2004, 24(2):70-72.
19.	Krasinskas AM, Demetris AJ, Poterucha JJ, et al. The prevalence and natural history of untreated isolated central perivenulitis in adult allograft livers[J]. Liver Transpl, 2008, 14(5):625-632.
20.	巴明臣, 张红卫, 陈训如, 等.胆囊镜胆囊切除术中放置腹腔引流管的临床意义[J].肝胆胰外科杂志, 2000, 12(3):130-131, 136.
21.	赵树龙, 林浩, 姜波健, 等.腹腔引流在胆囊切除术中的作用[J].肝胆胰外科杂志, 1999, 11(1):20.
22.	饶建华, 吕凌, 张峰, 等.腹腔引流术在肝脏切除术后应用的心要性探讨[J].中华普通外科杂志, 2010, 25(4):303-305.
23.	Krasinskas AM, Ruchelli ED, Rand EB, et al. Central venulitis in pediatric liver allografts[J]. Hepatology, 2001, 33(5):1141-1147.
24.	Banff Working Group, Demetris AJ, Adeyi O, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction[J]. Hepatology, 2006, 44(2):489-501.
25.	赵志坚, 唐才喜, 冯斌, 等.快速康复外科理念指导下腹腔镜胆道探查术的前瞻性随机对照临床研究[J].中国内镜杂志, 2013, 19(6):575-580.
26.	陈迅, 唐才喜, 冯斌, 等.胆道术后快速康复中早期T管夹闭的临床研究[J].医学临床研究, 2010, 27(9):1719-1721.
27.	伍晓汀, 周勇.腹腔引流管的正确选择和合理应用[J], 中国实用外科杂志, 2005, 25(1):35-36.

1. 洪德飞, 彭淑牖.腹腔镜肝胆胰脾外科手术操作与技巧[M].北京:人民卫生出版社, 2008:74.
2. 徐大华.微创外科时代的机遇、挑战和思考[J].中华肝胆外科杂志, 2011, 17(8):603-605.
3. 蔡阳, 朱玮, 封光华, 等. EST严重并发症的外科治疗[J].中华肝胆外科杂志, 2005, 11(9):616-617.
4. 张雷达, 王曙光, 别平, 等.不同方式的腹腔镜胆道探查术治疗胆总管结石的临床前瞻性研究[J].中国内镜杂志, 2006, 12(5):474-477.
5. Costamagna G, Tringali A, Shah SK, et al. Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence[J]. Endoscopy, 2002, 34(4):273-279.
6. 刘卫怀, 李吉, 胡志霞, 等.腹腔镜技术在肝外胆管结石治疗中的应用分析[J].中华肝胆外科杂志, 2010, 16(6):473-474.
7. 杨春明.胆总管结石的治疗选择[J].中华普通外科杂志, 2010, 25(10):858-860.
8. 罗昆仑, 方征, 余锋, 等.腹腔镜经胆囊管开口微切开胆管并一期缝合胆管治疗胆囊结石合并胆管结石[J].中华肝胆外科杂志, 2013, 19(5):349-351.
9. 戴途, 李建平, 陈波, 等.腹腔镜联合超细纤维胆道镜治疗胆总管结石[J].中华消化内镜杂志, 2005, 22(5):334-335.
10. 钱礼, 郑树森, 张启瑜, 等.钱礼腹部外科学[M].北京:人民卫生出版社, 2006:877.
11. 王俊, 孙权.胆总管探查后一期缝合并术中置胆道内支架引流术与T管引流术的比较[J].中国普通外科杂志, 2011, 20(8):85l-853.
12. 李凯旋, 廖永锋, 吴绍全, 等.选择性胆总管探查术一期缝合38例[J].实用医学杂志, 2012, 28(4):680-681.
13. Ambreen M, Shaikh AR, Jamal A, et al. Primary closure versus T-tube drainage after open choledochotomy[J]. Asian J Surg, 2009, 32(1):21-25.
14. 汤晓东, 刘双海, 蒋剑, 等.不同方式腹腔镜胆道探查术治疗肝外胆管结石的临床研究[J].中华肝胆外科杂, 2013, 19(8):589-592.
15. 沈汉斌, 郑启昌.腹腔镜胆总管探查术后拔T管胆漏的防治[J].中国普通外科杂志, 2005, 14(9):715-716.
16. 李留峥, 罗开元, 冉江华.胆总管切开探查一期缝合胆管的临床应用[J].肝胆外科杂志, 2005, 13(1):39-41.
17. 蔡珍福, 王坚, 周玉坤, 等.胆总管切开纤维胆道镜探查一期缝合695例分析[J].肝胆胰外科杂志, 2004, 16(2):110-111.
18. 窦科峰, 李海民.肝胆管结石的综合治疗与个体化处理[J].中国实用外科杂志, 2004, 24(2):70-72.
19. Krasinskas AM, Demetris AJ, Poterucha JJ, et al. The prevalence and natural history of untreated isolated central perivenulitis in adult allograft livers[J]. Liver Transpl, 2008, 14(5):625-632.
20. 巴明臣, 张红卫, 陈训如, 等.胆囊镜胆囊切除术中放置腹腔引流管的临床意义[J].肝胆胰外科杂志, 2000, 12(3):130-131, 136.
21. 赵树龙, 林浩, 姜波健, 等.腹腔引流在胆囊切除术中的作用[J].肝胆胰外科杂志, 1999, 11(1):20.
22. 饶建华, 吕凌, 张峰, 等.腹腔引流术在肝脏切除术后应用的心要性探讨[J].中华普通外科杂志, 2010, 25(4):303-305.
23. Krasinskas AM, Ruchelli ED, Rand EB, et al. Central venulitis in pediatric liver allografts[J]. Hepatology, 2001, 33(5):1141-1147.
24. Banff Working Group, Demetris AJ, Adeyi O, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction[J]. Hepatology, 2006, 44(2):489-501.
25. 赵志坚, 唐才喜, 冯斌, 等.快速康复外科理念指导下腹腔镜胆道探查术的前瞻性随机对照临床研究[J].中国内镜杂志, 2013, 19(6):575-580.
26. 陈迅, 唐才喜, 冯斌, 等.胆道术后快速康复中早期T管夹闭的临床研究[J].医学临床研究, 2010, 27(9):1719-1721.
27. 伍晓汀, 周勇.腹腔引流管的正确选择和合理应用[J], 中国实用外科杂志, 2005, 25(1):35-36.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic Cholecystectomy and Common Bile Duct Exploration with Biliary Stent Drainage or T Tube Drainage in Treatment of Extrahepatic Bile Duct Stones

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