Clinical study of exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

PENG Shasha , GUO Jun , PEI Fei , FANG Tao ,  XIA Guobing

Department of Hepatobiliary Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi, Hubei 435000, P. R. China;

Corresponding author：

XIA Guobing, Email: 734750263@qq.com

Keywords：

hepatolithiasis; hepatectomy; laparoscope; choledochoscopic exploration

DOI：

10.7507/1007-9424.201705068

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate feasibility and clinical efficacy of exploration and stone removal through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis. Methods The patients who had left extrahepatic bile duct stones with choledocholithiasis from January 2012 to December 2016 were retrospectively collected. Among these patients, 29 cases underwent an exploration and stone removal through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy (observation group) and 26 cases underwent an exploration and stone removal through choledochoscope via incision of common bile duct during laparoscopic left lateral hepatectomy (control group). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative nutritional, and complications rate were compared between these two groups. Results The operations were performed successfully and no perioperative death happened in both groups. There were no significant differences in the operative time and intraoperative blood loss between the two groups (P>0.05). Moreover, the postoperative hospital stay of the observation group was significantly shorter than that of the control group (P<0.05). In addition, there were no significant differences in the complications of the bile leakage, subphrenic infection, and biliary residual stones between the two groups (P>0.05). Also, the levels of prealbumin and the lymphocytes in the observation group were significantly higher than those in the control group on the 3rd and 6th day after the operation (P<0.05). Conclusions Preliminary results of limited cases in this study show that exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis is relatively safe and reliable, its procedure is simplified, could avoid relevant complications due to biliary incision and T tube drainage.

Citation： PENG Shasha, GUO Jun, PEI Fei, FANG Tao, XIA Guobing. Clinical study of exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(11): 1357-1360. doi: 10.7507/1007-9424.201705068 Copy

1.	刘子旭, 曹迁, 凌晓锋. 肝内胆管结石病治疗进展. 实用医学杂志, 2016, 32(4): 513-515.
2.	夏志超, 曾仲, 黄汉飞, 等. " 七步断肝法”在腹腔镜肝左外叶切除术中的临床应用. 实用医学杂志, 2016, 32(17): 2942-2943.
3.	吕立升, 魏妙艳, 汤朝晖. 肝胆管结石成因及分型. 中国实用外科杂志, 2016, 36(3): 348-350.
4.	何小东, 刘乔飞. 肝胆管结石病的诊断与治疗. 中华消化外科杂志, 2015, 14(4): 275-279.
5.	殷晓煜. 肝切除在肝胆管结石治疗中的作用及地位. 中国实用外科杂志, 2016, 36(3): 278-280.
6.	任旋磊, 沙洪存, 洪晓明, 等. 腹腔镜左半肝切除治疗左肝内胆管结石. 中华普通外科杂志, 2016, 31(7): 579-581.
7.	Namgoong JM, Kim KH, Park GC, et al. Comparison of laparoscopic versus open left hemihepatectomy for left-sided hepatolithiasis. Int J Med Sci, 2014, 11(2): 127-133.
8.	Kim YK, Han HS, Yoon YS, et al. Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment. World J Surg, 2015, 39(5): 1224-1230.
9.	Lin CC, Lin PY, Ko CJ, et al. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg, 2013, 83(12): 978-984.
10.	彭沙沙, 黄汉飞, 段键, 等. 胆囊结石继发胆总管结石行胆道探查一期缝合125例. 中国普通外科杂志, 2014, 23(8): 1126-1128.
11.	周文星, 吕传新, 宋超, 等. 消化液收集回输对肠内营养支持治疗患者的影响. 广东医学, 2014, 35(21): 3359-3361.
12.	陈永标, 池小斌, 江艺, 等. 腹腔镜肝切除联合胆道镜治疗肝内外胆管结石 36 例. 中国微创外科杂志, 2016, 16(9): 777-779.
13.	Catena M, Aldrighetti L, Finazzi R, et al. Treatment of non-endemic hepatolithiasis in a Western country. The role of hepatic resection. Ann R Coll Surg Engl, 2006, 88(4): 383-389.
14.	Borzellino G, Ruzzenente A, Minicozzi AM, et al. Laparoscopic hepatic resection. Surg Endosc, 2006, 20(5): 787-790.
15.	Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
16.	El-Geidie AA. Is the use of T-tube necessary after laparoscopic choledochotomy? J Gastrointest Surg, 2010, 14(5): 844-848.
17.	宋戈, 王海久, 李晓龙, 等. 肝癌患者临床营养评价方法及其进展. 中国普外基础与临床杂志, 2017, 24(6): 760-764.
18.	孙晓东, 孙大伟, 王广义. 微创技术在肝胆管结石诊治中应用进展. 中国实用外科杂志, 2016, 36(3): 337-340.
19.	Peng L, Xiao J, Liu Z, et al. Laparoscopic left-sided hepatectomy for the treatment of hepatolithiasis: A comparative study with open approach. Int J Surg, 2017, 40: 117-123.

1. 刘子旭, 曹迁, 凌晓锋. 肝内胆管结石病治疗进展. 实用医学杂志, 2016, 32(4): 513-515.
2. 夏志超, 曾仲, 黄汉飞, 等. " 七步断肝法”在腹腔镜肝左外叶切除术中的临床应用. 实用医学杂志, 2016, 32(17): 2942-2943.
3. 吕立升, 魏妙艳, 汤朝晖. 肝胆管结石成因及分型. 中国实用外科杂志, 2016, 36(3): 348-350.
4. 何小东, 刘乔飞. 肝胆管结石病的诊断与治疗. 中华消化外科杂志, 2015, 14(4): 275-279.
5. 殷晓煜. 肝切除在肝胆管结石治疗中的作用及地位. 中国实用外科杂志, 2016, 36(3): 278-280.
6. 任旋磊, 沙洪存, 洪晓明, 等. 腹腔镜左半肝切除治疗左肝内胆管结石. 中华普通外科杂志, 2016, 31(7): 579-581.
7. Namgoong JM, Kim KH, Park GC, et al. Comparison of laparoscopic versus open left hemihepatectomy for left-sided hepatolithiasis. Int J Med Sci, 2014, 11(2): 127-133.
8. Kim YK, Han HS, Yoon YS, et al. Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment. World J Surg, 2015, 39(5): 1224-1230.
9. Lin CC, Lin PY, Ko CJ, et al. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg, 2013, 83(12): 978-984.
10. 彭沙沙, 黄汉飞, 段键, 等. 胆囊结石继发胆总管结石行胆道探查一期缝合125例. 中国普通外科杂志, 2014, 23(8): 1126-1128.
11. 周文星, 吕传新, 宋超, 等. 消化液收集回输对肠内营养支持治疗患者的影响. 广东医学, 2014, 35(21): 3359-3361.
12. 陈永标, 池小斌, 江艺, 等. 腹腔镜肝切除联合胆道镜治疗肝内外胆管结石 36 例. 中国微创外科杂志, 2016, 16(9): 777-779.
13. Catena M, Aldrighetti L, Finazzi R, et al. Treatment of non-endemic hepatolithiasis in a Western country. The role of hepatic resection. Ann R Coll Surg Engl, 2006, 88(4): 383-389.
14. Borzellino G, Ruzzenente A, Minicozzi AM, et al. Laparoscopic hepatic resection. Surg Endosc, 2006, 20(5): 787-790.
15. Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
16. El-Geidie AA. Is the use of T-tube necessary after laparoscopic choledochotomy? J Gastrointest Surg, 2010, 14(5): 844-848.
17. 宋戈, 王海久, 李晓龙, 等. 肝癌患者临床营养评价方法及其进展. 中国普外基础与临床杂志, 2017, 24(6): 760-764.
18. 孙晓东, 孙大伟, 王广义. 微创技术在肝胆管结石诊治中应用进展. 中国实用外科杂志, 2016, 36(3): 337-340.
19. Peng L, Xiao J, Liu Z, et al. Laparoscopic left-sided hepatectomy for the treatment of hepatolithiasis: A comparative study with open approach. Int J Surg, 2017, 40: 117-123.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical study of exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis

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