ObjectiveTo explore the clinical efficacy and surgical techniques of laparoscopic choledocholithotomy and primary suture. MethodsWe retrospectively analyzed the clinical data of 58 patients who underwent laparoscopic choledocholithotomy and primary suture between January 2009 and December 2014. ResultsAll the 58 patients underwent the surgery successfully. Operation time was 45-125 minutes, averaging 75 minutes. Intraoperative blood loss was between 10 and 50 mL with an average of 20 mL. Postoperative hospital stay was 5-14 days with an average of 7 days. Four cases of biliary leakage were cured by conservative treatment. ConclusionWith operation indications strictly grasped and skillful operation techniques, laparoscopic choledocholithotomy and primary suture are safe and reliable with a good curative effect.
ObjectiveTo explore the value of laparoscopic choledocholithotomy on hepatolithiasis patients with previous bile duct surgery contraindicating hepatectomy. MethodsEighty-six hepatolithiasis patients contraindicating hepatectomy accepted laparoscopic choledocholithotomy during March 2009 and March 2013 in the department of general surgery, AVIC 363 hospital. Among them, 26 cases with previous bile duct surgery(PBS group) and 60 cases without (NPBS group), 15 cases with left intrahepatic bile duct stone, 52 cases with right intrahepatic bile duct stone, and 19 cases with bilateral intrahepatic bile duct stone. Perioperative materials were reviewed between two groups retrospectively. ResultsThe operation time of the PBS group and NPBS group was(161.4±31.5) min and(155.7±28.1) min respectively(P > 0.05). And the intraoperative blood loss of them was(69.2±50.7) mL and(44.1±27.4) mL respectively (P < 0.05). Postoperative complication incidence of PBS group was 53.8%, among them, ascites was found obviously much more in PBS group than that in NPBS group(P < 0.05). The general residual stone incidence of two groups was 15.1%, and the general stone clearance rate was 98.8%. The long term postoperative complication occurrence in PBS group was 23.1%, which was higher significantly than that in NPBS group(P<0.05). ConclusionLaparoscopic choledocholithotomy is a safe, effective thus feasible choice for hepatolithiasis patients with previous bile duct surgery, especially for those without hepatic atrophy, bilateral hepatic bile ducts stone with hepatic bile duct stricture and hepatic bile duct stone with coexisting biliary cirrhosis.