Treatment of Cholecystolithiasis Combined with Calculus of Common Bile Duct by Laparoscopy with Combination of Choledochoscope and Duodenoscope_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Lan , ZHANG Shu , HUANG Dequan , YANG Yicun , CAO Yang , YAO Xinmin , XI Weidong

Department of General Surgery, The Third People’s Hospital of Chengdu City, ChinaCorresponding Author: ZHANG Shu, E-mail: sssyyy22@163.com;

Corresponding author：

Keywords：

Laparoscope; Choledochoscope; Duodenoscope; Cholecystolithiasis; Calculus of common bile duct

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　　Objective 　To investigate the method of the treatment on cholecystolithiasis combined with calculus of common bile duct (CBD) by laparoscopy with combination of choledochoscope and duodenoscope and its significances.
　　Methods 　Forty-two patients with cholecystolithiasis combined with calculus of CBD were treated by laparoscopy with combination of choledochoscope and duodenoscope from Jan. 2007 to Dec. 2008 in this hospital. Under general anesthesia, laparoscopic cholecystectomy was performed first, then the anterior wall of CBD was opened, calculus of CBD was treated by choledochoscope and duodenoscope intraoperatively. Then primary suture of the CBD was performed under laparoscope and nasobiliary drainage duct was placed.
　　Results 　One case was converted to laparotomy, 41 cases succeeded and left hospital after being taken off the nasobiliary drainage duct in 5-7 d. No case died, no bile leakage, no bleeding or perforation of upper digestive tract, and no acute pancreatitis happened after operation.
　　Conclusion 　Laparoscopy with combination of choledochoscope and duodenoscope treating cholecystolithiasis combined with calculus of CBD is a safe, effective and quickly recovering method with less sufferings and trauma.

Citation： YU Lan,ZHANG Shu,HUANG Dequan,YANG Yicun,CAO Yang,YAO Xinmin,XI Weidong. Treatment of Cholecystolithiasis Combined with Calculus of Common Bile Duct by Laparoscopy with Combination of Choledochoscope and Duodenoscope. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(4): 323-325. doi: Copy

1.	秦明放, 邹富胜, 王庆, 等. 三镜联合治疗肝外胆管结石(附251例报告) [J]. 中国实用外科杂志, 2002; 22(10): 597-599.
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3.	Qin MF, Xu HB. Combined laparoscopic and endoscopic trea-tment for bile duct diseases [J]. Hepatobiliary Pancreat Dis Int, 2004; 3(2): 284-287.
4.	皮勇, 陈德杰, 陈志丹, 等. 腔镜胆总管切开术与内镜联合腹腔镜治疗胆总管结石的临床分析 [J]. 临床外科杂志, 2008; 16(6): 392-394.
5.	〖JP3〗黄小兵, 梁平, 李靖, 等. 三镜联合治疗胆囊结石并胆总管结石的临床初步探讨 [J]. 实用医学杂志, 2007; 23(4): 519-520.
6.	Liyanage CA, Sadakari Y, Lenaga J, et al. Endoscopic management of a difficult common bile duct stone [J]. Ceylon Med J, 2008; 53(3): 105-106.
7.	李霖, 梁驰. “三镜”联合治疗胆总管结石的临床研究 [J]. 微创医学, 2008; 3(4): 314-317.
8.	Karaliotas C, Sgourakis G, Goumas C, et al. Laparoscopic common bile duct exploration after failed endoscopic stone extraction [J]. Surg Endosc, 2008; 22(8): 1826-1831.
9.	李兆申, 许国铭. 胰腺疾病内镜诊断与治疗学 [M]. 上海: 第二军医大学出版社, 2004: 1.
10.	陶涛, 石刚, 彭祥玉, 等. 腹腔镜和胆道镜联合治疗胆总管结石（附523例报道） [J]. 中国普外基础与临床杂志, 2009; 16(8): 649-653.
11.	陈佐会, 罗平. 内镜、腹腔镜联合治疗胆囊结石合并胆总管结石（附51例报告） [J]. 中国普外基础与临床杂志, 2005; 12(6): 569-570.
12.	胡三元. 肝内、外胆管结石的腹腔镜处理 [J]. 中国普外基础与临床杂志, 2008; 15(10): 711-713.
13.	顾思平, 冉江华, 周晓明, 等. 术中输尿管镜气压弹道碎石治疗胆总管下段嵌顿性结石19例报道 [J]. 中国普外基础与临床杂志, 2007; 14(3): 330-331.
14.	García-Cano J, Pérez Sola A, Gómez Ruiz CJ, et al. Extraction of a big-sized common bile duct stone by means of biliary sphincterotomy followed by papillary dilatation with a hydrostatic balloon[J]. Rev Esp Enferm Dig, 2008; 100(6): 361-362.
15.	孙利国, 刘小敏. 胆总管切开取石Ⅰ期缝合64例报道 [J]. 中国普外基础与临床杂志, 2007; 14(1): 109.
16.	王晓军, 韩威, 李建设. 腹腔镜联合胆道镜治疗胆总管结石50例报告 [J]. 临床和实验医学杂志, 2008; 7(6): 56-57.
17.	Mori A, Sakai K, Ohashi N, et al. Lectrohydraulic lithotripsy of the common bile duct stone under transnasal direct cholangioscopy [J]. Endoscopy, 2008; 40 Suppl 2: E63.
18.	黄昌州, 胡海, 赵中辛. 腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石 [J]. 中国普通外科杂志, 2008; 17(2): 114-116.
19.	马宁, 葛春林, 龙锦, 等. 腹腔镜联合内镜治疗58例胆囊结石合并胆总管结石 [J]. 中国医师杂志, 2007; 9(12): 1677-1678.
20.	蔡柳新, 方哲平, 杜学峰, 等. 腹腔镜、十二指肠镜、胆管镜联合治疗胆囊伴胆总管结石 [J]. 现代中西医结合杂志, 2008; 17(1): 64-65.
21.	彭颖, 王立新, 徐智, 等. 内镜腹腔镜联合与腹腔镜下联合方法治疗胆囊结石合并胆总管结石的临床对照 [J]. 中华消化内镜杂志, 2007; 24(5): 342-345.
22.	赵普, 莫耀良, 唐传军, 等. 腹腔镜、胆道镜联合治疗胆总管结石的临床研究 [J]. 腔镜外科杂志, 2007; 12(4): 325-326.
23.	林建华, 周杰, 崔忠林. 十二指肠镜和腹腔镜联合治疗胆囊结石合并胆总管结石 [J]. 中国内镜杂志, 2007; 13(4): 405-406,409.
24.	吕忠. 三镜联合胆总管一期缝合治疗胆囊、胆总管结石 [J]. 肝胆胰外科杂志, 2006; 18(4): 242-243.
25.	易斌, 尹思能, 陈安平, 等. 腹腔镜联合十二指肠镜治疗胆囊合并胆总管结石 [J]. 医学新知杂志, 2006; 16(5): 315-316.
26.	范康川. 三镜联合治疗胆总管结石的临床应用研究 [J]. 中华现代外科学杂志, 2006; 3(20): 1646-1647.

1. 秦明放, 邹富胜, 王庆, 等. 三镜联合治疗肝外胆管结石(附251例报告) [J]. 中国实用外科杂志, 2002; 22(10): 597-599.
2. 　Sgourakis G, Karaliotas K. Laparoscopic common bile duct exploration and cholecystectomy versus endoscopic stone extraction and laparoscopic cholecystectomy for choledocholithiasis. A prospective randomized study [J]. Minerva Chir, 2002; 57(4): 467-474.
3. 　Qin MF, Xu HB. Combined laparoscopic and endoscopic trea-tment for bile duct diseases [J]. Hepatobiliary Pancreat Dis Int, 2004; 3(2): 284-287.
4. 　皮勇, 陈德杰, 陈志丹, 等. 腔镜胆总管切开术与内镜联合腹腔镜治疗胆总管结石的临床分析 [J]. 临床外科杂志, 2008; 16(6): 392-394.
5. 　〖JP3〗黄小兵, 梁平, 李靖, 等. 三镜联合治疗胆囊结石并胆总管结石的临床初步探讨 [J]. 实用医学杂志, 2007; 23(4): 519-520.
6. 　Liyanage CA, Sadakari Y, Lenaga J, et al. Endoscopic management of a difficult common bile duct stone [J]. Ceylon Med J, 2008; 53(3): 105-106.
7. 　李霖, 梁驰. “三镜”联合治疗胆总管结石的临床研究 [J]. 微创医学, 2008; 3(4): 314-317.
8. 　Karaliotas C, Sgourakis G, Goumas C, et al. Laparoscopic common bile duct exploration after failed endoscopic stone extraction [J]. Surg Endosc, 2008; 22(8): 1826-1831.
9. 　李兆申, 许国铭. 胰腺疾病内镜诊断与治疗学 [M]. 上海: 第二军医大学出版社, 2004: 1.
10. 　陶涛, 石刚, 彭祥玉, 等. 腹腔镜和胆道镜联合治疗胆总管结石（附523例报道） [J]. 中国普外基础与临床杂志, 2009; 16(8): 649-653.
11. 　陈佐会, 罗平. 内镜、腹腔镜联合治疗胆囊结石合并胆总管结石（附51例报告） [J]. 中国普外基础与临床杂志, 2005; 12(6): 569-570.
12. 　胡三元. 肝内、外胆管结石的腹腔镜处理 [J]. 中国普外基础与临床杂志, 2008; 15(10): 711-713.
13. 　顾思平, 冉江华, 周晓明, 等. 术中输尿管镜气压弹道碎石治疗胆总管下段嵌顿性结石19例报道 [J]. 中国普外基础与临床杂志, 2007; 14(3): 330-331.
14. 　García-Cano J, Pérez Sola A, Gómez Ruiz CJ, et al. Extraction of a big-sized common bile duct stone by means of biliary sphincterotomy followed by papillary dilatation with a hydrostatic balloon[J]. Rev Esp Enferm Dig, 2008; 100(6): 361-362.
15. 　孙利国, 刘小敏. 胆总管切开取石Ⅰ期缝合64例报道 [J]. 中国普外基础与临床杂志, 2007; 14(1): 109.
16. 　王晓军, 韩威, 李建设. 腹腔镜联合胆道镜治疗胆总管结石50例报告 [J]. 临床和实验医学杂志, 2008; 7(6): 56-57.
17. 　Mori A, Sakai K, Ohashi N, et al. Lectrohydraulic lithotripsy of the common bile duct stone under transnasal direct cholangioscopy [J]. Endoscopy, 2008; 40 Suppl 2: E63.
18. 　黄昌州, 胡海, 赵中辛. 腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石 [J]. 中国普通外科杂志, 2008; 17(2): 114-116.
19. 　马宁, 葛春林, 龙锦, 等. 腹腔镜联合内镜治疗58例胆囊结石合并胆总管结石 [J]. 中国医师杂志, 2007; 9(12): 1677-1678.
20. 　蔡柳新, 方哲平, 杜学峰, 等. 腹腔镜、十二指肠镜、胆管镜联合治疗胆囊伴胆总管结石 [J]. 现代中西医结合杂志, 2008; 17(1): 64-65.
21. 　彭颖, 王立新, 徐智, 等. 内镜腹腔镜联合与腹腔镜下联合方法治疗胆囊结石合并胆总管结石的临床对照 [J]. 中华消化内镜杂志, 2007; 24(5): 342-345.
22. 　赵普, 莫耀良, 唐传军, 等. 腹腔镜、胆道镜联合治疗胆总管结石的临床研究 [J]. 腔镜外科杂志, 2007; 12(4): 325-326.
23. 　林建华, 周杰, 崔忠林. 十二指肠镜和腹腔镜联合治疗胆囊结石合并胆总管结石 [J]. 中国内镜杂志, 2007; 13(4): 405-406,409.
24. 　吕忠. 三镜联合胆总管一期缝合治疗胆囊、胆总管结石 [J]. 肝胆胰外科杂志, 2006; 18(4): 242-243.
25. 　易斌, 尹思能, 陈安平, 等. 腹腔镜联合十二指肠镜治疗胆囊合并胆总管结石 [J]. 医学新知杂志, 2006; 16(5): 315-316.
26. 　范康川. 三镜联合治疗胆总管结石的临床应用研究 [J]. 中华现代外科学杂志, 2006; 3(20): 1646-1647.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Treatment of Cholecystolithiasis Combined with Calculus of Common Bile Duct by Laparoscopy with Combination of Choledochoscope and Duodenoscope

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