| Analysis of curative effect of laparoscopic cholecystectomy guided by the bile duct |
| Received:April 25, 2019 Revised:November 15, 2019 Click here to download the full text |
| Citation of this paper:ZHOU Zhao,ZHU Jian-fei,ZHU Chun-fu.Analysis of curative effect of laparoscopic cholecystectomy guided by the bile duct[J].Chinese Journal of Clinical Medicine,2020,27(1):88-90 |
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| Author Name | Affiliation | E-mail | | ZHOU Zhao | Department of Hepatobiliary Pancreatic Surgery, the 2nd People's Hospital of Changzhou, Nanjing Medical University, Changzhou 213003, Jiangsu, China | | | ZHU Jian-fei | Department of Hepatobiliary Pancreatic Surgery, the 2nd People's Hospital of Changzhou, Nanjing Medical University, Changzhou 213003, Jiangsu, China | | | ZHU Chun-fu | Department of Hepatobiliary Pancreatic Surgery, the 2nd People's Hospital of Changzhou, Nanjing Medical University, Changzhou 213003, Jiangsu, China | zcfmlm@njmu.edu.cn |
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| Abstract:Objective: To explore the feasibility, safety, and clinical significance of laparoscopic cholecystectomy guided by the bile duct (LCGBD). Methods: The clinical data of 456 patients underwent laparoscopic cholecystectomy (LC) from March 2013 to April 2017 were analyzed retrospectively. The surgical dissection of the Calot's triangle was initially performed from the caudal to the cephalic along the right edge of the common bile duct and common hepatic duct. After all the structures, including the cystic duct, cystic artery, and bile duct, were distinctly exposed, the cystic duct was clipped and cut near its junction with bile duct. Resection of the cystic artery was afterwards performed. The gallbladder was ultimately resected when the above procedures were finished. Results: Of the 456 patients, 451 patients (98.9%) were successfully treated with LCGBD. Five patients (1.1%) failed to undergo LCGBD because of tight adhesion in the Calot's triangle, Mirrizzi syndrome, bile duct variation, or hemorrhage of gallbladder bed. Totally, 75 patients were found with biliary tract variations, 32 cases with minute stones in the cystic duct. No sever complication occurred, such as bile duct injury, bile leakage, major intraperitoneal hemorrhage, or reoperation. Two patients were converted to open laparotomy because of biliary tract variation or hemorrhage of gallbladder bed. There were 3 patients with post-operation abdominal residual infection, 2 patients with subxiphoid trocar wound infection. All patients with infection were cured with conservative therapy. The postoperative follow-up time ranged from 3 to 45 months, with an average of (25.1±14.6) months. There were no patients with biliary stricture or residual calculus. Conclusions: LCGBD is an effective, feasible, and safe method in facilitating the dissection of the Calot's triangle and discovery of anatomical variations, and is beneficial to reduce the incidences of biliary duct injury, hemorrhage, and other sever surgical complications. |
| keywords:laparoscopic cholecystectomy Calot triangle complications bile duct |
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