Risk and Therapy Strategy of Tiny Gallbladder Stones During Laparoscopic Cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGWei ^1,2 , GONGRen-hua ¹ , LILei ² ,  CAOBao-qiang ¹

1. Department of General Surgery, Armed Police Anhui Corps Hospital, Hefei 230061, Anhui Province, China;
2. Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China;

Corresponding?author：

CAOBao-qiang, Email: caobaoqiang@126.com

Keywords：

Laparoscopic cholecystectomy; Tiny gallbladder stone; Risk; Therapy strategy

DOI：

10.7517/1007-9424.20150255

Video：

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ObjectiveTo analyze risk and therapy strategy of tiny gallbladder stones during laparoscopic cholecystectomy (LC).MethodThe clinical data of 932 patients with tiny gallbladder stones performed LC from September 2013 to July 2014 were analyzed retrospectively.ResultsThe LC was successful in all the patients. The gallbladders were ruptured in 86 (9.23%) patients during operation. Following up 1-3 months, there were 26 patients with right upper abdominal pain and with residual small stones in the abdominal cavity, 57 patients without uncomfortable symptoms and without residual gallstone, 2 cases complicated with lesser abdominal abscess, 1 case complicated with incision infection. The incisional hernia and acute pancreatitis were not found.ConclusionsThe gallbladder with full of tiny stones performed LC easily leads to choledocholithiasis or acute pancreatitis. If intraoperative gallbladder rupture, the tiny stones might be residual in the peritoneal cavity and lead to abdominal infection or abscess, and incision infection or trocar site hernia. Specific operation could effectively avoid adverse complications.

Citation： WANGWei, GONGRen-hua, LILei, CAOBao-qiang. Risk and Therapy Strategy of Tiny Gallbladder Stones During Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 981-984. doi: 10.7517/1007-9424.20150255 Copy

1.	楊曉軍, 高鵬, 司若湟, 等.常規/選擇性膽道造影在腹腔鏡膽囊切除術中的應用研究.中國普外基礎與臨床雜志, 2012, 19(10):1105-1109.
2.	De Carvalho LF, Fierens K, Kint M. Mini-laparoscopic versus conven-tional laparoscopic cholecystectomy:a randomized controlled trial. J Laparoendosc Adv Surg Tech A, 2013, 23(2):109-116.
3.	McDonald MP, Munson JL, Sanders L, et al. Consequences of lost gallstone. Surg Endosc, 1997, 11(7):774-777.
4.	Kurbanov FS, Alievlu G, Chinnikov MA, et al. Laparoscopic cholec-ystectomy in case of acute cholecystitis. Khirurqiia (Mosk), 2014, 5(2):16-18.
5.	Manukyan MN, Demirkalem P, Gulluoglu BM, et al. Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg, 2005, 189(4):451-452.
6.	Karsenti D. Endoscopic management of bile duct stones:residual bile duct stones after surgery, cholangitis, and "difficult stones". J Visc Surg, 2013, 151(3 Suppl):S39-S46.
7.	張淼, 張云, 魚海峰, 等.膽管結石再手術治療策略探討.中國現代普通外科進展, 2012, 15(6):492-494.
8.	Shapey IM, Jaunoo SS, Arachchilage KM, et al. Biliary tract imaging for retained calculi after laparoscopic cholecystectomy:is risk stratification useful? Surg Laparosc Endosc Percutan Tech, 2012, 22(5):459-462.
9.	Qin M, Zou F, Zhao H, et al. Minimally invasive phasic treatment protocol for the treatment of extrahepatic bile duct stones. J Laparoendosc Adv Surg Tech A, 2012, 22(8):797-801.
10.	陶東升, 蔣結志, 葉臨生, 等.腹腔鏡膽囊切除聯合術中膽道造影的應用.肝膽外科雜志, 2014, 22(6):462-463.
11.	李文.腹腔鏡膽囊切除術中膽道造影負壓抽吸取石術的應用.中國普通外科雜志, 2013, 22(8):1087-1089.
12.	孫振芝, 操海舟, 李少偉, 等.腹腔鏡膽囊切除術中膽道造影的臨床價值研究.中國醫藥導報, 2013, 10(36):55-57.
13.	熊仁海, 黃緒群, 吳瓊, 等.腹腔鏡膽囊切除術中膽囊破裂的臨床分析(附305例報告).腹腔鏡外科雜志, 2012, 17(8):592-594.
14.	Dobradin A, Jugmohan S, Dabul L. Gallstone-related abdominal abscess 8 years after laparoscopic cholecystectomy. JSLS, 2013, 17(1):139-142.
15.	鐘先榮, 盧榜裕, 陳澤華, 等.腹腔鏡膽囊切除術腹腔殘留膽石對術后機體的影響.中國普外基礎與臨床雜志, 2010, 17(7):744-745.
16.	高允海, 馮雷, 韓柯鑫.急性膽囊炎腹腔鏡切除術中膽囊破裂相關處理及預后分析.中國老年學雜志, 2014, 34(14):4051-4051.
17.	張勇, 陳衛, 王雪峰, 等.腹腔鏡膽囊切除術中膽囊破裂的原因及其處理.上海第二醫科大學學報, 2004, 24(8):674-675, 687.
18.	尚亞飛, 呂毅, 慕喜喜, 等.腹腔鏡膽囊切除術后腹腔殘留結石致成人臍尿管囊腫感染1例報告.中國實用外科雜志, 2014, 34(5):470-471.
19.	冉瑞圖.關于膽囊切除術的幾點意見.中國普外基礎與臨床雜志, 2008, 15(2):81-82.
20.	廖小鳳.超聲下膽道系統結石與氣體的鑒別要點.中國醫藥指南, 2012, 10(9):512-513.
21.	Regoly MJ, Ihasz M. The sequelae of retained or lost stones:A complication of laparoscopic cholecystectomy. Surg Endosc, 2005, 9(8):931-932.
22.	陳明福.腹腔引流在腹腔鏡膽囊切除術中的作用及指征.中國普通外科雜志, 2008, 17(6):623-624.
23.	朱維銘.腹部手術引流的正確置放和引流物判斷.中國實用外科雜志, 2011, 31(1):66-68.
24.	孫楓林, 李曉軍, 馬楊, 等.膽囊微小結石與膽源性胰腺炎關系的回顧性分析.中國現代普通外科進展, 2010, 13(6):499-510.
25.	周霖.自制內鏡推吸套管在治療膽囊多發碎小結石、泥沙樣結石中的應用.中國醫藥科學, 2012, 2(13):167, 169.

1. 楊曉軍, 高鵬, 司若湟, 等.常規/選擇性膽道造影在腹腔鏡膽囊切除術中的應用研究.中國普外基礎與臨床雜志, 2012, 19(10):1105-1109.
2. De Carvalho LF, Fierens K, Kint M. Mini-laparoscopic versus conven-tional laparoscopic cholecystectomy:a randomized controlled trial. J Laparoendosc Adv Surg Tech A, 2013, 23(2):109-116.
3. McDonald MP, Munson JL, Sanders L, et al. Consequences of lost gallstone. Surg Endosc, 1997, 11(7):774-777.
4. Kurbanov FS, Alievlu G, Chinnikov MA, et al. Laparoscopic cholec-ystectomy in case of acute cholecystitis. Khirurqiia (Mosk), 2014, 5(2):16-18.
5. Manukyan MN, Demirkalem P, Gulluoglu BM, et al. Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg, 2005, 189(4):451-452.
6. Karsenti D. Endoscopic management of bile duct stones:residual bile duct stones after surgery, cholangitis, and "difficult stones". J Visc Surg, 2013, 151(3 Suppl):S39-S46.
7. 張淼, 張云, 魚海峰, 等.膽管結石再手術治療策略探討.中國現代普通外科進展, 2012, 15(6):492-494.
8. Shapey IM, Jaunoo SS, Arachchilage KM, et al. Biliary tract imaging for retained calculi after laparoscopic cholecystectomy:is risk stratification useful? Surg Laparosc Endosc Percutan Tech, 2012, 22(5):459-462.
9. Qin M, Zou F, Zhao H, et al. Minimally invasive phasic treatment protocol for the treatment of extrahepatic bile duct stones. J Laparoendosc Adv Surg Tech A, 2012, 22(8):797-801.
10. 陶東升, 蔣結志, 葉臨生, 等.腹腔鏡膽囊切除聯合術中膽道造影的應用.肝膽外科雜志, 2014, 22(6):462-463.
11. 李文.腹腔鏡膽囊切除術中膽道造影負壓抽吸取石術的應用.中國普通外科雜志, 2013, 22(8):1087-1089.
12. 孫振芝, 操海舟, 李少偉, 等.腹腔鏡膽囊切除術中膽道造影的臨床價值研究.中國醫藥導報, 2013, 10(36):55-57.
13. 熊仁海, 黃緒群, 吳瓊, 等.腹腔鏡膽囊切除術中膽囊破裂的臨床分析(附305例報告).腹腔鏡外科雜志, 2012, 17(8):592-594.
14. Dobradin A, Jugmohan S, Dabul L. Gallstone-related abdominal abscess 8 years after laparoscopic cholecystectomy. JSLS, 2013, 17(1):139-142.
15. 鐘先榮, 盧榜裕, 陳澤華, 等.腹腔鏡膽囊切除術腹腔殘留膽石對術后機體的影響.中國普外基礎與臨床雜志, 2010, 17(7):744-745.
16. 高允海, 馮雷, 韓柯鑫.急性膽囊炎腹腔鏡切除術中膽囊破裂相關處理及預后分析.中國老年學雜志, 2014, 34(14):4051-4051.
17. 張勇, 陳衛, 王雪峰, 等.腹腔鏡膽囊切除術中膽囊破裂的原因及其處理.上海第二醫科大學學報, 2004, 24(8):674-675, 687.
18. 尚亞飛, 呂毅, 慕喜喜, 等.腹腔鏡膽囊切除術后腹腔殘留結石致成人臍尿管囊腫感染1例報告.中國實用外科雜志, 2014, 34(5):470-471.
19. 冉瑞圖.關于膽囊切除術的幾點意見.中國普外基礎與臨床雜志, 2008, 15(2):81-82.
20. 廖小鳳.超聲下膽道系統結石與氣體的鑒別要點.中國醫藥指南, 2012, 10(9):512-513.
21. Regoly MJ, Ihasz M. The sequelae of retained or lost stones:A complication of laparoscopic cholecystectomy. Surg Endosc, 2005, 9(8):931-932.
22. 陳明福.腹腔引流在腹腔鏡膽囊切除術中的作用及指征.中國普通外科雜志, 2008, 17(6):623-624.
23. 朱維銘.腹部手術引流的正確置放和引流物判斷.中國實用外科雜志, 2011, 31(1):66-68.
24. 孫楓林, 李曉軍, 馬楊, 等.膽囊微小結石與膽源性胰腺炎關系的回顧性分析.中國現代普通外科進展, 2010, 13(6):499-510.
25. 周霖.自制內鏡推吸套管在治療膽囊多發碎小結石、泥沙樣結石中的應用.中國醫藥科學, 2012, 2(13):167, 169.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk and Therapy Strategy of Tiny Gallbladder Stones During Laparoscopic Cholecystectomy

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