Diagnostic and Laparoscopic Surgical Treatment of Calculus of Cystic Duct_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 JIANGPing , ZHENGXiang-yun , CHEHan-yang , LIUHai-bin

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China;

Corresponding author：

JIANGPing, Email: jiangstjst@163.com

Keywords：

Laparoscopic cholecystectomy; Cystic duct; Calculus

DOI：

10.7507/1007-9424.20150124

Video：

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Objectives To investigate the diagnosis and laparoscopic surgical treatment methods of calculus of cystic duct. Methods The clinical data of 147 patients with calculus of cystic duct underwent laparoscopic cholecystectomy (LC) in the Second Affiliated Hospital of Wenzhou Medical College from June 2008 to June 2013 were analyzed retrospectively. Results Among the 147 patients with calculus of cystic duct, 19 cases were given preoperative diagnosis by B-ultrasound and CT scanning, 128 cases were found by exploration in operation; 146 cases underwent LC successfully and 1 case was converted to laparotomy.The 147 cases were followed-up for 3 months to 2 years with an average of 7 months and all cases were out of bile duct injury, hemorrhage, bile leakage, residual calculi or other complications. Conclusions Preoperative diagnosis of calculus of cystic duct is difficult, meanwhile, routine intraoperative probe is very necessary for the diagnosis of calculus of cystic duct.Proficiency in surgical technique with laparoscopic treatment of calculus of cystic duct is the key to the success of LC.

Citation： JIANGPing, ZHENGXiang-yun, CHEHan-yang, LIUHai-bin. Diagnostic and Laparoscopic Surgical Treatment of Calculus of Cystic Duct. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(4): 472-474. doi: 10.7507/1007-9424.20150124 Copy

1.	Reshetnyak VI.Concept of the pathogenesis and treatment of holelithiasis.World J Hepatol, 2012, 4(2):18-34.
2.	陈金明, 陈吉林, 毛泽军.腹腔镜胆囊切除术治疗胆囊管结石92例.中国中西医结合外科杂志, 2012, 18(4):409-410.
3.	Low SW, Iyer SG, Chang SK, et al.Laparoscopic cholecystectomy for acute cholecystitis:safe implementation of successful strategies to reduce conversion rates.Surg Endosc, 2009, 23(11):2424-2429.
4.	费维国, 姚坦.胆囊切除术后残余胆囊结石例诊治分析.中华普通外科杂志, 2009, 3(2):145-146.
5.	Mahmud S, Hamza Y, Nassar AH.The significance of cystic duct stones encountered during laparoscopic cholecystectomy.Surg Endosc, 2001, 15(5):460-462.
6.	Demetriades H, Pramateftakis MG, Kanellos I, et al.Retained gallbladder remnant after laparoscopic cholecystectomy.J Laparoendosc Adv Surg Tech A, 2008, 18(2):276-279.
7.	付振刚, 陈广瑜, 成广海, 等.困难腹腔镜胆囊切除术的手术经验(附128例报道).中国普外基础与临床杂志, 2014, 21(8):954-956.
8.	孙书祥.胆囊管结石术后的诊治体会.临床误诊误治, 2007, 20(6):65.
9.	何海清, 伍华飞.腹腔镜胆囊切除术及保胆取石术处理胆囊管结石的体会.腹腔镜外科杂志, 2011, 16(10):779-780.
10.	Turner MA, Fulcher AS.The cystic duct:normal anatomy and disease processes.Radiographics, 2001, 21(1):3-22.
11.	Walsh RM, Ponsky JL, Dumot J.Retained gallbladder/cystic duct remnant calculi as a cause of postcholecystectomy pain.Surg Endosc, 2002, 16(6):981-984.
12.	裘法祖, 王建本, 张祐曾.腹部外科临床解剖学.济南:山东科学技术出版社, 2001:183-185.
13.	Laing FC, Jeffrey RB Jr.Choledocholithiasis and cystic duct obstruction:difficult ultrasonographic diagnosis.Radiology, 1983, 146(2):475-479.
14.	蔡华杰, 郑志海, 周振旭, 等.胆囊管结石的诊断和腹腔镜胆囊切除术中的处理策略.肝胆胰外科杂志, 2012, 24(6):481-483.
15.	张诚, 杨玉龙, 林美举, 等.胆囊管结石的保胆手术策略.中国内镜杂志, 2012, 18(10):1023-1027.
16.	Schmidt R, Tannheimer M, Danz B, et al.Clinical relevance of a routinely performed magnetic resonance cholangiopancreato-graphy (MRCP) prior to cholecystectomy.Zentralbl Chir, 2012, 137 (6):541-548.
17.	蔡茁, 黄志新, 娄安亭, 等.合并胆囊管结石的腹腔镜胆囊切除术.肝胆外科杂志, 2013 21(1):51-53.
18.	呼勤.腹腔镜胆囊管结石手术治疗36例分析.大家健康:学术版, 2013, 7(11):146-147.
19.	Horwood J, Akbar F, Davis K, et al.Prospective evaluation of a selective approach to cholangiography for suspected common bile duct stones.Ann R Coll Surg Engl, 2010, 92(3):206.
20.	戚仁华, 杨正荣, 李建军, 等.LC术中胆囊管结石的判断与处理.安徽医药, 2013, 17(7):1187-1188.
21.	邓天工, 牛秀莉, 姚婷, 等.胆囊管结石嵌顿合并胆囊管坏疽断裂1例报告及文献复习.中国微创外科杂志, 2014, 14(1):90-91.
22.	苏旭, 李滨.腹腔镜手术治疗胆囊管结石31例临床分析.肝胆胰外科杂志, 2011, 23(2):148-149.
23.	唐湘莲, 蒋平, 李利义, 等.腹腔镜手术治疗胆囊管结石76例分析.中国实用外科杂志, 2009, 29(2):152-153.
24.	罗丁, 陈训如, 毛静熙, 等.腹腔镜胆囊切除术中特殊类型胆囊管的处理.中华肝胆外科杂志, 2004, 10(2):103-104.
25.	汤庆峰, 戴德祥, 王绍勇.腹腔镜手术治疗嵌顿性胆囊结石的经验.中国普外基础与临床杂志, 2006, 13(4):401-402.

1. Reshetnyak VI.Concept of the pathogenesis and treatment of holelithiasis.World J Hepatol, 2012, 4(2):18-34.
2. 陈金明, 陈吉林, 毛泽军.腹腔镜胆囊切除术治疗胆囊管结石92例.中国中西医结合外科杂志, 2012, 18(4):409-410.
3. Low SW, Iyer SG, Chang SK, et al.Laparoscopic cholecystectomy for acute cholecystitis:safe implementation of successful strategies to reduce conversion rates.Surg Endosc, 2009, 23(11):2424-2429.
4. 费维国, 姚坦.胆囊切除术后残余胆囊结石例诊治分析.中华普通外科杂志, 2009, 3(2):145-146.
5. Mahmud S, Hamza Y, Nassar AH.The significance of cystic duct stones encountered during laparoscopic cholecystectomy.Surg Endosc, 2001, 15(5):460-462.
6. Demetriades H, Pramateftakis MG, Kanellos I, et al.Retained gallbladder remnant after laparoscopic cholecystectomy.J Laparoendosc Adv Surg Tech A, 2008, 18(2):276-279.
7. 付振刚, 陈广瑜, 成广海, 等.困难腹腔镜胆囊切除术的手术经验(附128例报道).中国普外基础与临床杂志, 2014, 21(8):954-956.
8. 孙书祥.胆囊管结石术后的诊治体会.临床误诊误治, 2007, 20(6):65.
9. 何海清, 伍华飞.腹腔镜胆囊切除术及保胆取石术处理胆囊管结石的体会.腹腔镜外科杂志, 2011, 16(10):779-780.
10. Turner MA, Fulcher AS.The cystic duct:normal anatomy and disease processes.Radiographics, 2001, 21(1):3-22.
11. Walsh RM, Ponsky JL, Dumot J.Retained gallbladder/cystic duct remnant calculi as a cause of postcholecystectomy pain.Surg Endosc, 2002, 16(6):981-984.
12. 裘法祖, 王建本, 张祐曾.腹部外科临床解剖学.济南:山东科学技术出版社, 2001:183-185.
13. Laing FC, Jeffrey RB Jr.Choledocholithiasis and cystic duct obstruction:difficult ultrasonographic diagnosis.Radiology, 1983, 146(2):475-479.
14. 蔡华杰, 郑志海, 周振旭, 等.胆囊管结石的诊断和腹腔镜胆囊切除术中的处理策略.肝胆胰外科杂志, 2012, 24(6):481-483.
15. 张诚, 杨玉龙, 林美举, 等.胆囊管结石的保胆手术策略.中国内镜杂志, 2012, 18(10):1023-1027.
16. Schmidt R, Tannheimer M, Danz B, et al.Clinical relevance of a routinely performed magnetic resonance cholangiopancreato-graphy (MRCP) prior to cholecystectomy.Zentralbl Chir, 2012, 137 (6):541-548.
17. 蔡茁, 黄志新, 娄安亭, 等.合并胆囊管结石的腹腔镜胆囊切除术.肝胆外科杂志, 2013 21(1):51-53.
18. 呼勤.腹腔镜胆囊管结石手术治疗36例分析.大家健康:学术版, 2013, 7(11):146-147.
19. Horwood J, Akbar F, Davis K, et al.Prospective evaluation of a selective approach to cholangiography for suspected common bile duct stones.Ann R Coll Surg Engl, 2010, 92(3):206.
20. 戚仁华, 杨正荣, 李建军, 等.LC术中胆囊管结石的判断与处理.安徽医药, 2013, 17(7):1187-1188.
21. 邓天工, 牛秀莉, 姚婷, 等.胆囊管结石嵌顿合并胆囊管坏疽断裂1例报告及文献复习.中国微创外科杂志, 2014, 14(1):90-91.
22. 苏旭, 李滨.腹腔镜手术治疗胆囊管结石31例临床分析.肝胆胰外科杂志, 2011, 23(2):148-149.
23. 唐湘莲, 蒋平, 李利义, 等.腹腔镜手术治疗胆囊管结石76例分析.中国实用外科杂志, 2009, 29(2):152-153.
24. 罗丁, 陈训如, 毛静熙, 等.腹腔镜胆囊切除术中特殊类型胆囊管的处理.中华肝胆外科杂志, 2004, 10(2):103-104.
25. 汤庆峰, 戴德祥, 王绍勇.腹腔镜手术治疗嵌顿性胆囊结石的经验.中国普外基础与临床杂志, 2006, 13(4):401-402.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic and Laparoscopic Surgical Treatment of Calculus of Cystic Duct

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