Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007， 113 patients including chronic gallstone cholecystitis （n=55）, inactive cholecystolithiasis （n=46） and gallbladder polyps （n=12） were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation， 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC， 3 months and 6 months after LC were (5±2) mm, (8±2) mm and (6±2) mm respectively. And in chronic gallstone cholecystitis patients they were (5±2) mm, (9±2) mm and (6±2) mm respectively， in inactive gallstone cholelithiasis patients they were (5±2) mm, (8±2) mm and (6±2) mm respectively， and in gallbladder polyps ones they were (5±2) mm, (7±2) mm and (5±2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.
【Abstract】ObjectiveTo evaluate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosis of extrahepatic bile duct obstruction. MethodsMRCP images of 42 patients presented clinically with obstructive jaundice were retrospectively reviewed to assess the lumen morphological abnormalities of benign versus malignant bile duct obstructions, with clinicalpathological correlation. ResultsThe bile duct of the 30 cases of benign biliary obstruction presented regular and symmetric dilation, gradual tapering,regular thickening and had a “beaklike” tip. The accuracy of MRCP for evaluating the site and the etiology of the benign biliary obstruction were 100%(30/30) and 97%(29/30) respectively. The bile duct of the 12 cases of malignant biliary obstruction presented irregular and asymmetric dilation,abrupt narrowing or iterruption,irregular thickening and had “dualduct sign”. The accuracy of MRCP for evaluating the site and the etiology of the malignant biliary obstruction were 100%(12/12) and 92%(11/12) respectively. ConclusionMRCP is the noninvasive technique of choice with excellent accuracy for the evaluation of obstructive biliary pathology.
ObjectiveTo investigate the efficacy and safety of laparoscopic cholecystectomy and common bile duct exploration(LCBDE) with biliary stent drainage or T tube drainage. MethodsThe 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). ResultsThe 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). ConclusionsThe 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.