Objective
To explore the value for localization of cystic lymph node in laparoscopic cholecystectomy.
Methods
Clinical data of 100 cases who underwent laparoscopic cholecystectomy in Affiliated Hospital of Southern Medical University and The Third Division Hospital of Xinjiang Production and Construction Corps were collected to analyze retrospectively, for exploring the relationship of localization of cystic lymph node, cystic artery, cystic duct, and liver door.
Results
Of the 100 cases, 81 cases (81.0%) were found lymph node, in which 76 cases (76.0%) were found 1 lymph node and 5 cases(5.0%) were found lymph node more than 1, the other 19 cases(19.0%) were not found lymph node. Of the 76 cases who were found only 1 lymph node, lymph nodes were located above the anterior branch of cystic artery in 48 cases, below the anterior branch of cystic artery in 21 cases, and adjacent to the posterior branch of cystic artery in 7 cases. The operation was successful in all patients without death, of which 3 cases were transferred to laparotomy. The operation time were (43.0±6.5) min (25-116 min), and hospital stay after operation were (3.0±0.6) days (2-6 days). No serious complications of bile leakage, bile duct injury, and death happened after operation, and all cases were cured and discharged.
Conclusion
Cystic lymph node in the calot triangle is in relatively fixed position of laparoscopic cholecystectomy, it can help to guide judging anatomical hepatic portal region of each organization structure, and can to confirm the location of cystic artery and cystic duct, which is helpful to prevent injury during the operation of laparoscopic cholecystectomy.
Citation:
ZHANGWei-yao, RAOZhi, PANLei. Study of Cystic Lymph Node as A Location Sign in Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(9): 1134-1137. doi: 10.7507/1007-9424.20140272
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- 1. 祁军安, 江奎, 朱海林, 等.12729例腹腔镜胆囊切除术并发症原因分析及对策探讨[J]. 腹腔镜外科杂志, 2009, 14(5):362-365.
- 2. 曹月敏.腹腔镜胆囊切除术胆管损伤的预防、诊断与治疗[J]. 中国微创外科杂志, 2005, 5(11):960-961.
- 3. 吴孟超, 吴在德.黄家驷外科学[M]. 第7版.北京:人民卫生出版社, 2008:1784-1800.
- 4. 陈训如, 田伏洲, 黄大熔.微创胆道外科手术学[M]. 北京:军事医学科学出版社, 1988:530.
- 5. 黄志强.肝脏外科手术学[M]. 北京:人民军医出版社, 1996:27.
- 6. 沈魁, 何三光.实用普通外科手术学[M]. 辽宁:辽宁教育出版社, 1988:530.
- 7. 王殿臣, 董永红, 陈智, 等.三结构确认胆囊管在预防腹腔镜胆囊切除术胆管损伤中的价值[J]. 中华医学杂志, 2009, 89(6):406-408.