Laparoscopy Combined with Choledochoscopy in Treatment of Schistosomiasis Liver Cirrhosis with Common Bile Duct Stone_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGJian-xin ,  JINWei-dong , CAIXun , ZHANGZhi-yong , YEJia-xin , MADan-dan

Department of General Surgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, Hubei Province, China;

Corresponding author：

JINWei-dong, Email: mai_andy0@126.com

Keywords：

Common bile duct stone; Schistosomiasis liver cirrhosis; Minimally invasive treatment

DOI：

10.7507/1007-9424.20160348

Video：

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Objective To summarize experience of laparoscopy combined with choledochoscopy common bile duct exploration for patients with schistosomiasis liver cirrhosis with common bile duct stones. Method The clinical data of 45 patients with schistosomiasis liver cirrhosis combined with common bile duct stones (liver function Child-Pugh grade A and B) admitted in this hospital from September 2012 to September 2015 were analyzed retrospectively. Results Twenty cases were successfully treated by laparoscopy combined with choledochoscopy (laparoscope group), 25 cases were treated by conventional open common bile duct exploration (laparotomy group). Two cases were converted to laparotomy due to bleeding during laparoscopic operation. The mean operation time, intraoperative bleeding, postopera-tive hospitalization time, and postoperative total complications rate had no significant differences between these two groups (P>0.05). There were 2 cases of pulmonary infection and 1 case of incision infection in the laparoscope group, and 1 case of grade A bile leakage and 1 case of pulmonary infection in the laparotomy group, there was no common bile duct stone residual in these two groups. Conclusion Although laparoscopic surgery is more difficult for schistosomiasis liver cirrhosis combined with common bile duct stones patients, it is safe and feasible. Appropriate perioperative management and precise laparoscopic and choledochoscopic operation are key to success of operation.

Citation： ZHANGJian-xin, JINWei-dong, CAIXun, ZHANGZhi-yong, YEJia-xin, MADan-dan. Laparoscopy Combined with Choledochoscopy in Treatment of Schistosomiasis Liver Cirrhosis with Common Bile Duct Stone. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1362-1365. doi: 10.7507/1007-9424.20160348 Copy

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2.	陈明, 钟恩鹏. 肝硬化合并胆囊结石的外科治疗. 中国普通外科杂志, 2015, 24(6):907-909.
3.	Butt Z, Hyder Q. Cholelithiasis in hepatic cirrhosis:evaluating the role of risk factors. J Pak Med Assoc, 2010, 60(8):641-644.
4.	张雪瑞,翟建. 血吸虫病肝脏的影像学表现. 医学综述, 2009, 15(7):1094-1096.
5.	赵挺. 血吸虫性肝硬化病人腹腔镜胆囊切除术的特殊性. 浙江实用医学, 2002, 7(5):267, 271.
6.	陈中, 倪家连, 刘鲁岳, 等. 肝硬化门静脉高压症合并胆石症的处理分析. 中国普通外科杂志, 2011, 20(2):206-207.
7.	Paganini AM, Guerrieri M, Sarnari J, et al. Thirteen years, experience with laparoscopic transcystic common bile duct exploration for stones. Effectiveness and long-term results. Surg Endosc, 2007, 21(1):34-40.
8.	黄志强. 变幻世纪中的外科:挑战与对策. 中华实验外科杂志, 2007, 24(2):133-134.
9.	范瑞芳, 肖毅, 任彦顺, 等. 腹腔镜联合胆道镜微创治疗老年人胆总管结石及胆囊结石的临床研究. 西北国防医学杂志, 2014, 35(5):416-419.
10.	游蓁, 叶辉, 熊先泽, 等. LC+LCBDE与ERCP/EST+LC治疗胆囊结石合并胆总管结石的梗阻性黄疸患者的临床对照研究. 中国普外基础与临床杂志, 2013, 220(11):1268-1271.
11.	Borzellino G, Rodella L, Saladino E, et al. Treatment for retained[corrected] common bile duct stones during laparoscopic cholecyste-ctomy:the rendezvous technique. Arch Surg, 2010, 145(12):1145-1149.
12.	Zang JF, Zhang C, Gao JY. Endoscopic retrograde cholangiopancre-atography and laparoscopic cholecystectomy during the same session:feasibility and safety. World J Gastroenterol, 2013, 19(36):6093-6097.
13.	菅志远, 沈先锋, 黄林生, 等. 三种微创方式治疗胆囊结石合并胆总管结石的临床疗效分析. 中国普通外科杂志, 2015, 24(2):275-279.
14.	Ding G, Cai W, Qin M. Single-stage vs. two-stage management for concomitant gallstones and common bile duct stones:a prospective randomized trial with long-term follow-up. J Gastrointest Surg, 2014, 18(5):947-951.
15.	Kim KY, Han J, Kim HG, et al. Late complications and stone recurr-ence rates after bile duct stone removal by endoscopic sphinctero-tomy and large balloon dilation are similar to those after endoscopic sphincterotomy alone. Clin Endosc, 2013, 46(6):637-642.
16.	徐琳, 王峰, 张宇飞, 等. 内镜下乳头切开与开腹胆道探查治疗胆总管结石合并肝硬化的疗效比较. 外科理论与实践, 2011, 16(6):587-588.
17.	Shelat VG, Chan CY, Liau KH, et al. Laparoscopic exploration can salvage failed endoscopic bile duct stone extraction. Singapore Med J, 2012, 53(5):313-317.
18.	Lee HM, Min SK, Lee HK. Long-term results of laparoscopic common bile duct exploration by choledochotomy for choledocholithiasis:15-year experience from a single center. Ann Surg Treat Res, 2014, 86(1):1-6.
19.	谢朝晖, 钟勇. 腹腔镜联合纤维胆道镜胆总管探查术的临床应用. 西部医学, 2012, 24(10):1894-1896.
20.	Sharma A, Dahiya P, Khullar R, et al. Management of common bile duct stones in the laparoscopic era. Indian J Surg, 2012, 74(3):264-269.
21.	Zhou Y, Wu XD, Fan RG, et al. Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg, 2014, 12(7):645-648.
22.	徐红星, 徐海宾, 顾玉青, 等. 腹腔镜胆总管探查术后一期缝合与T管引流的临床研究. 中国普外基础与临床杂志, 2015, 22(10):1254-1256.
23.	鲁珅, 许军. 不同CO₂气腹压力对肝硬化病人肝功能影响的临床观察. 齐齐哈尔医学院报, 2008, 29(3):279-281.

1. Silva MA, Wong T. Gallstones in chronic liver disease. J Gastroin-test Surg, 2005, 9(5):739-746.
2. 陈明, 钟恩鹏. 肝硬化合并胆囊结石的外科治疗. 中国普通外科杂志, 2015, 24(6):907-909.
3. Butt Z, Hyder Q. Cholelithiasis in hepatic cirrhosis:evaluating the role of risk factors. J Pak Med Assoc, 2010, 60(8):641-644.
4. 张雪瑞,翟建. 血吸虫病肝脏的影像学表现. 医学综述, 2009, 15(7):1094-1096.
5. 赵挺. 血吸虫性肝硬化病人腹腔镜胆囊切除术的特殊性. 浙江实用医学, 2002, 7(5):267, 271.
6. 陈中, 倪家连, 刘鲁岳, 等. 肝硬化门静脉高压症合并胆石症的处理分析. 中国普通外科杂志, 2011, 20(2):206-207.
7. Paganini AM, Guerrieri M, Sarnari J, et al. Thirteen years, experience with laparoscopic transcystic common bile duct exploration for stones. Effectiveness and long-term results. Surg Endosc, 2007, 21(1):34-40.
8. 黄志强. 变幻世纪中的外科:挑战与对策. 中华实验外科杂志, 2007, 24(2):133-134.
9. 范瑞芳, 肖毅, 任彦顺, 等. 腹腔镜联合胆道镜微创治疗老年人胆总管结石及胆囊结石的临床研究. 西北国防医学杂志, 2014, 35(5):416-419.
10. 游蓁, 叶辉, 熊先泽, 等. LC+LCBDE与ERCP/EST+LC治疗胆囊结石合并胆总管结石的梗阻性黄疸患者的临床对照研究. 中国普外基础与临床杂志, 2013, 220(11):1268-1271.
11. Borzellino G, Rodella L, Saladino E, et al. Treatment for retained[corrected] common bile duct stones during laparoscopic cholecyste-ctomy:the rendezvous technique. Arch Surg, 2010, 145(12):1145-1149.
12. Zang JF, Zhang C, Gao JY. Endoscopic retrograde cholangiopancre-atography and laparoscopic cholecystectomy during the same session:feasibility and safety. World J Gastroenterol, 2013, 19(36):6093-6097.
13. 菅志远, 沈先锋, 黄林生, 等. 三种微创方式治疗胆囊结石合并胆总管结石的临床疗效分析. 中国普通外科杂志, 2015, 24(2):275-279.
14. Ding G, Cai W, Qin M. Single-stage vs. two-stage management for concomitant gallstones and common bile duct stones:a prospective randomized trial with long-term follow-up. J Gastrointest Surg, 2014, 18(5):947-951.
15. Kim KY, Han J, Kim HG, et al. Late complications and stone recurr-ence rates after bile duct stone removal by endoscopic sphinctero-tomy and large balloon dilation are similar to those after endoscopic sphincterotomy alone. Clin Endosc, 2013, 46(6):637-642.
16. 徐琳, 王峰, 张宇飞, 等. 内镜下乳头切开与开腹胆道探查治疗胆总管结石合并肝硬化的疗效比较. 外科理论与实践, 2011, 16(6):587-588.
17. Shelat VG, Chan CY, Liau KH, et al. Laparoscopic exploration can salvage failed endoscopic bile duct stone extraction. Singapore Med J, 2012, 53(5):313-317.
18. Lee HM, Min SK, Lee HK. Long-term results of laparoscopic common bile duct exploration by choledochotomy for choledocholithiasis:15-year experience from a single center. Ann Surg Treat Res, 2014, 86(1):1-6.
19. 谢朝晖, 钟勇. 腹腔镜联合纤维胆道镜胆总管探查术的临床应用. 西部医学, 2012, 24(10):1894-1896.
20. Sharma A, Dahiya P, Khullar R, et al. Management of common bile duct stones in the laparoscopic era. Indian J Surg, 2012, 74(3):264-269.
21. Zhou Y, Wu XD, Fan RG, et al. Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg, 2014, 12(7):645-648.
22. 徐红星, 徐海宾, 顾玉青, 等. 腹腔镜胆总管探查术后一期缝合与T管引流的临床研究. 中国普外基础与临床杂志, 2015, 22(10):1254-1256.
23. 鲁珅, 许军. 不同CO₂气腹压力对肝硬化病人肝功能影响的临床观察. 齐齐哈尔医学院报, 2008, 29(3):279-281.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopy Combined with Choledochoscopy in Treatment of Schistosomiasis Liver Cirrhosis with Common Bile Duct Stone

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