Efficacy analysis of primary closure with two or three endoscopes through cystic duct for treatment of gallbladder stone with secondary common bile duct stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TANG Shichuan , PENG Wenbin , ZHENG Qinyue , LIU Jinheng , CHEN Anping ,  YIN Sineng

Department of Hepatobiliary Surgery, Chengdu Affiliated Hospital of Zunyi Medical University (Chengdu Second People’s Hospital), Chengdu 610015, P. R. China;

Corresponding author：

YIN Sineng, Email: doctoryinsn@sina.com

Keywords：

gallbladder stone with secondary common bile duct stone; transcystic duct pathway; two endoscopes; three endoscopes; primary closure

DOI：

10.7507/1007-9424.201909066

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate clinical efficacy and advantages and disadvantages of primary closure with two endoscopes (1aparoscope+choledochoscope) or three endoscopes (laparoscope+choledochoscope+duodenoscope) through the cystic duct for treatment of gallbladder stone with secondary common bile duct (CBD) stones.Methods The clinical data of 83 patients with gallbladder stones with secondary CBD stones treated by two or three endoscopes combined with CBD exploration and lithotomy and primary closure through cystic duct from January 2017 to December 2018 in the Chengdu Second People’s Hospital were collected retrospectively. Among them, 41 patients were treated by two endoscopes mode (two endoscopes group), 42 cases were treated by three endoscopes mode (three endoscopes group).Results There were no significant differences in the general conditions such as the gender, age, preoperative diameter of CBD, chronic diseases, etc. between the two and three endoscopes group (P>0.05). All 83 cases underwent the operations successfully and recovered well. The success rate of operation, stone clearance rate, drainage volume of abdominal drainage tube on day 1 after the operation, time of abdominal drainage tube removal after the operation, and hospitalization time had no significant differences between these two groups (P>0.05). The time of operation, intraoperative bleeding volume, and the postoperative pancreatitis rate in the three endoscopes group were significantly more (or higher) than those in the two endoscopes group (P<0.05), but the condition of liver function recovered after the operation was better than that in the two endoscopes group (P<0.05).Conclusions With the strict control of the operation indications, it is safe and feasible to use two or three endoscopes through the cystic duct pathway and primary closure of CBD for treatment of gallbladder stone with secondary CBD stones. However, the choice of operative methods of two or three endoscopes should be based on the general situation of the patients before and during the operation.

Citation： TANG Shichuan, PENG Wenbin, ZHENG Qinyue, LIU Jinheng, CHEN Anping, YIN Sineng. Efficacy analysis of primary closure with two or three endoscopes through cystic duct for treatment of gallbladder stone with secondary common bile duct stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(7): 819-824. doi: 10.7507/1007-9424.201909066 Copy

1.	Demirbas BT, Gulluoglu BM, Aktan AO. Retained abdominal gallstones after laparoscopic cholecystectomy: a systematic review. Surg Laparosc Endosc Percutan Tech, 2015, 25(2): 97-99.
2.	Williams EJ, Green J, Beckingham I, et al. Guidelines on the management of common bile duct stones (CBDS). Gut, 2008, 57(7): 1004-1021.
3.	何恒正, 周峥, 尹清华, 等. ERCP+LC和LC+LCBDE治疗胆囊结石合并胆总管结石的效果比较. 实用医学杂志, 2018, 34(11): 1889-1892.
4.	Ricci C, Pagano N, Taffurelli G, et al. Comparison of efficacy and safety of 4 combinations of laparoscopic and intraoperative techniques for management of gallstone disease with biliary duct calculi: a systematic review and network meta-analysis. JAMA Surg, 2018, 153(7): e181167.
5.	National Clinical Guideline Centre. Gallstone disease: diagnosis and management of cholelithiasis, cholecystitis and choledocholithiasis. London: National Institute for Health and Care Excellence (UK), 2014.
6.	Mohamed MA, Bahram MA, Ammar MS, et al. One-session laparoscopic management of combined common bile duct and gallbladder stones versus sequential ERCP followed by laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A, 2015, 25(6): 482-485.
7.	Salama AF, Abd Ellatif ME, Abd Elaziz H, et al. Preliminary experience with laparoscopic common bile duct exploration. BMC Surg, 2017, 17(1): 32.
8.	Khaled YS, Malde DJ, de Souza C, et al. Laparoscopic bile duct exploration via choledochotomy followed by primary duct closure is feasible and safe for the treatment of choledocholithiasis. Surg Endosc, 2013, 27(11): 4164-4170.
9.	Bekheit M, Smith R, Ramsay G, et al. Meta-analysis of laparoscopic transcystic versus transcholedochal common bile duct exploration for choledocholithiasis. BJS Open, 2019, 3(3): 242-251.
10.	杨彦, 林师佈, 韩霖, 等. 腹腔镜联合胆道镜胆总管探查一期缝合术洽疗胆囊结石合并胆总管结石的临床效果分析. 临床肝胆病杂志, 2018, 34(3): 526-530.
11.	Hajibandeh S, Hajibandeh S, Sarma DR, et al. Laparoscopic transcystic versus transductal common bile duct exploration: a systematic review and meta-analysis. World J Surg, 2019, 43(8): 1935-1948.
12.	Gupta N. Role of laparoscopic common bile duct exploration in the management of choledocholithiasis. World J Gastrointest Surg, 2016, 8(5): 376-381.
13.	Lee JY, Keane MG, Pereira S. Diagnosis and treatment of gallstone disease. Practitioner, 2015, 259(1783): 15-19.
14.	Stoker ME, Leveillee RJ, McCann JCJR, et al. Laparoscopic common bile duct exploration. J Laparoendosc Surg, 1991, 1(5): 287-293.
15.	赵冬雨, 成丽娅, 于健. 胆囊结石继发胆总管结石不同手术方式的临床疗效分析. 中国普外基础与临床杂志, 2014, 21(4): 498-500.
16.	魏留田, 赵高峰, 欧阳荣. 腹腔镜下胆总管探查一期缝合术治疗胆总管结石的临床疗效. 肝胆外科杂志, 2018, 26(3): 212-215.
17.	Darrien JH, Connor K, Janeczko A, et al. The surgical management of concomitant gallbladder and common bile duct stones. HPB Surg, 2015, 2015: 165068.
18.	Aawsaj Y, Light D, Horgan L. Laparoscopic common bile duct exploration: 15-year experience in a district general hospital. Surg Endosc, 2016, 30(6): 2563-2566.
19.	张磊, 宋晓静, 周文策, 等. 十二指肠镜、电子胆道镜和腹腔镜序贯治疗胆总管结合合并胆囊结石834例临床观察. 临床肝胆病杂志, 2014, 30(5): 428-430.
20.	Cai H, Sun D, Sun Y, et al. Primary closure following laparoscopic common bile duct exploration combined with intraoperative cholangiography and choledochoscopy. World J Surg, 2012, 36(1): 164-170.
21.	Zhang WJ, Xu GF, Huang Q, et al. Treatment of gallbladder stone with common bile duct stones in the laparoscopic era. BMC Surg, 2015, 15: 7.
22.	Parra-Membrives P, Martínez-Baena D, Lorente-Herce J, et al. Comparative study of three bile duct closure methods following laparoscopic common bile duct exploration for choledocholithiasis. J Laparoendosc Adv Surg Tech A, 2018, 28(2): 145-151.
23.	梁廷波, 白雪莉, 陈伟. 腹腔镜胆总管探查术治疗胆总管结石的现状与进展. 中华消化外科杂志, 2018, 17(1): 22-25.
24.	李留峥, 向春明, 徐雷升, 等. 腹腔镜胆道探查取石术38例报道. 中国普外基础与临床杂志, 2015, 22(1): 23.
25.	Feng Q, Huang Y, Wang K, et al. Laparoscopic transcystic common bile duct exploration: advantages over laparoscopic choledochotomy. PLoS One, 2016, 11(9): e0162885.
26.	Pang L, Zhang Y, Wang Y, et al. Transcystic versus traditional laparoscopic common bile duct exploration: its advantages and a meta-analysis. Surg Endosc, 2018, 32(11): 4363-4376.
27.	Reinders JS, Gouma DJ, Ubbink DT, et al. Transcystic or transductal stone extraction during single-stage treatment of choledochocystolithiasis: a systematic review. World J Surg, 2014, 38(9): 2403-2411.
28.	Hanif F, Ahmed Z, Samie MA, et al. Laparoscopic transcystic bile duct exploration: the treatment of first choice for common bile duct stones. Surg Endosc, 2010, 24(7): 1552-1556.
29.	张明华, 刘瑞文, 陈健, 等. 腹腔镜胆囊切除术中运用胆道镜经胆囊管途径治疗胆总管结石. 肝胆胰外科杂志, 2016, 28(4): 319-321.
30.	Hongjun H, Yong J, Baoqiang W. Laparoscopic common bile duct exploration: choledochotomy versus transcystic approach? Surg Laparosc Endosc Percutan Tech, 2015, 25(3): 218-222.
31.	Fang L, Wang J, Dai WC, et al. Laparoscopic transcystic common bile duct exploration: surgical indications and procedure strategies. Surg Endosc, 2018, 32(12): 4742-4748.
32.	潘步建, 徐迈宇, 陈峰, 等. 腹腔镜下经胆囊管纤维胆道镜取石术治疗胆总管结石的临床研究. 中华普通外科杂志, 2015, 30(6): 485-486.
33.	Lei J, Wang J, Li Q, et al. Laparoscopic transcystic common bile duct exploration: T-shaped incision of cystic duct with freddy laser lithotripsy. J Laparoendosc Adv Surg Tech A, 2016, 26(8): 646-651.

1. Demirbas BT, Gulluoglu BM, Aktan AO. Retained abdominal gallstones after laparoscopic cholecystectomy: a systematic review. Surg Laparosc Endosc Percutan Tech, 2015, 25(2): 97-99.
2. Williams EJ, Green J, Beckingham I, et al. Guidelines on the management of common bile duct stones (CBDS). Gut, 2008, 57(7): 1004-1021.
3. 何恒正, 周峥, 尹清华, 等. ERCP+LC和LC+LCBDE治疗胆囊结石合并胆总管结石的效果比较. 实用医学杂志, 2018, 34(11): 1889-1892.
4. Ricci C, Pagano N, Taffurelli G, et al. Comparison of efficacy and safety of 4 combinations of laparoscopic and intraoperative techniques for management of gallstone disease with biliary duct calculi: a systematic review and network meta-analysis. JAMA Surg, 2018, 153(7): e181167.
5. National Clinical Guideline Centre. Gallstone disease: diagnosis and management of cholelithiasis, cholecystitis and choledocholithiasis. London: National Institute for Health and Care Excellence (UK), 2014.
6. Mohamed MA, Bahram MA, Ammar MS, et al. One-session laparoscopic management of combined common bile duct and gallbladder stones versus sequential ERCP followed by laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A, 2015, 25(6): 482-485.
7. Salama AF, Abd Ellatif ME, Abd Elaziz H, et al. Preliminary experience with laparoscopic common bile duct exploration. BMC Surg, 2017, 17(1): 32.
8. Khaled YS, Malde DJ, de Souza C, et al. Laparoscopic bile duct exploration via choledochotomy followed by primary duct closure is feasible and safe for the treatment of choledocholithiasis. Surg Endosc, 2013, 27(11): 4164-4170.
9. Bekheit M, Smith R, Ramsay G, et al. Meta-analysis of laparoscopic transcystic versus transcholedochal common bile duct exploration for choledocholithiasis. BJS Open, 2019, 3(3): 242-251.
10. 杨彦, 林师佈, 韩霖, 等. 腹腔镜联合胆道镜胆总管探查一期缝合术洽疗胆囊结石合并胆总管结石的临床效果分析. 临床肝胆病杂志, 2018, 34(3): 526-530.
11. Hajibandeh S, Hajibandeh S, Sarma DR, et al. Laparoscopic transcystic versus transductal common bile duct exploration: a systematic review and meta-analysis. World J Surg, 2019, 43(8): 1935-1948.
12. Gupta N. Role of laparoscopic common bile duct exploration in the management of choledocholithiasis. World J Gastrointest Surg, 2016, 8(5): 376-381.
13. Lee JY, Keane MG, Pereira S. Diagnosis and treatment of gallstone disease. Practitioner, 2015, 259(1783): 15-19.
14. Stoker ME, Leveillee RJ, McCann JCJR, et al. Laparoscopic common bile duct exploration. J Laparoendosc Surg, 1991, 1(5): 287-293.
15. 赵冬雨, 成丽娅, 于健. 胆囊结石继发胆总管结石不同手术方式的临床疗效分析. 中国普外基础与临床杂志, 2014, 21(4): 498-500.
16. 魏留田, 赵高峰, 欧阳荣. 腹腔镜下胆总管探查一期缝合术治疗胆总管结石的临床疗效. 肝胆外科杂志, 2018, 26(3): 212-215.
17. Darrien JH, Connor K, Janeczko A, et al. The surgical management of concomitant gallbladder and common bile duct stones. HPB Surg, 2015, 2015: 165068.
18. Aawsaj Y, Light D, Horgan L. Laparoscopic common bile duct exploration: 15-year experience in a district general hospital. Surg Endosc, 2016, 30(6): 2563-2566.
19. 张磊, 宋晓静, 周文策, 等. 十二指肠镜、电子胆道镜和腹腔镜序贯治疗胆总管结合合并胆囊结石834例临床观察. 临床肝胆病杂志, 2014, 30(5): 428-430.
20. Cai H, Sun D, Sun Y, et al. Primary closure following laparoscopic common bile duct exploration combined with intraoperative cholangiography and choledochoscopy. World J Surg, 2012, 36(1): 164-170.
21. Zhang WJ, Xu GF, Huang Q, et al. Treatment of gallbladder stone with common bile duct stones in the laparoscopic era. BMC Surg, 2015, 15: 7.
22. Parra-Membrives P, Martínez-Baena D, Lorente-Herce J, et al. Comparative study of three bile duct closure methods following laparoscopic common bile duct exploration for choledocholithiasis. J Laparoendosc Adv Surg Tech A, 2018, 28(2): 145-151.
23. 梁廷波, 白雪莉, 陈伟. 腹腔镜胆总管探查术治疗胆总管结石的现状与进展. 中华消化外科杂志, 2018, 17(1): 22-25.
24. 李留峥, 向春明, 徐雷升, 等. 腹腔镜胆道探查取石术38例报道. 中国普外基础与临床杂志, 2015, 22(1): 23.
25. Feng Q, Huang Y, Wang K, et al. Laparoscopic transcystic common bile duct exploration: advantages over laparoscopic choledochotomy. PLoS One, 2016, 11(9): e0162885.
26. Pang L, Zhang Y, Wang Y, et al. Transcystic versus traditional laparoscopic common bile duct exploration: its advantages and a meta-analysis. Surg Endosc, 2018, 32(11): 4363-4376.
27. Reinders JS, Gouma DJ, Ubbink DT, et al. Transcystic or transductal stone extraction during single-stage treatment of choledochocystolithiasis: a systematic review. World J Surg, 2014, 38(9): 2403-2411.
28. Hanif F, Ahmed Z, Samie MA, et al. Laparoscopic transcystic bile duct exploration: the treatment of first choice for common bile duct stones. Surg Endosc, 2010, 24(7): 1552-1556.
29. 张明华, 刘瑞文, 陈健, 等. 腹腔镜胆囊切除术中运用胆道镜经胆囊管途径治疗胆总管结石. 肝胆胰外科杂志, 2016, 28(4): 319-321.
30. Hongjun H, Yong J, Baoqiang W. Laparoscopic common bile duct exploration: choledochotomy versus transcystic approach? Surg Laparosc Endosc Percutan Tech, 2015, 25(3): 218-222.
31. Fang L, Wang J, Dai WC, et al. Laparoscopic transcystic common bile duct exploration: surgical indications and procedure strategies. Surg Endosc, 2018, 32(12): 4742-4748.
32. 潘步建, 徐迈宇, 陈峰, 等. 腹腔镜下经胆囊管纤维胆道镜取石术治疗胆总管结石的临床研究. 中华普通外科杂志, 2015, 30(6): 485-486.
33. Lei J, Wang J, Li Q, et al. Laparoscopic transcystic common bile duct exploration: T-shaped incision of cystic duct with freddy laser lithotripsy. J Laparoendosc Adv Surg Tech A, 2016, 26(8): 646-651.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Efficacy analysis of primary closure with two or three endoscopes through cystic duct for treatment of gallbladder stone with secondary common bile duct stones

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content