Clinical study of exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

PENG Shasha , GUO Jun , PEI Fei , FANG Tao ,  XIA Guobing

Department of Hepatobiliary Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi, Hubei 435000, P. R. China;

Corresponding?author：

XIA Guobing, Email: 734750263@qq.com

Keywords：

hepatolithiasis; hepatectomy; laparoscope; choledochoscopic exploration

DOI：

10.7507/1007-9424.201705068

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate feasibility and clinical efficacy of exploration and stone removal through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis. Methods The patients who had left extrahepatic bile duct stones with choledocholithiasis from January 2012 to December 2016 were retrospectively collected. Among these patients, 29 cases underwent an exploration and stone removal through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy (observation group) and 26 cases underwent an exploration and stone removal through choledochoscope via incision of common bile duct during laparoscopic left lateral hepatectomy (control group). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative nutritional, and complications rate were compared between these two groups. Results The operations were performed successfully and no perioperative death happened in both groups. There were no significant differences in the operative time and intraoperative blood loss between the two groups (P>0.05). Moreover, the postoperative hospital stay of the observation group was significantly shorter than that of the control group (P<0.05). In addition, there were no significant differences in the complications of the bile leakage, subphrenic infection, and biliary residual stones between the two groups (P>0.05). Also, the levels of prealbumin and the lymphocytes in the observation group were significantly higher than those in the control group on the 3rd and 6th day after the operation (P<0.05). Conclusions Preliminary results of limited cases in this study show that exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis is relatively safe and reliable, its procedure is simplified, could avoid relevant complications due to biliary incision and T tube drainage.

Citation： PENG Shasha, GUO Jun, PEI Fei, FANG Tao, XIA Guobing. Clinical study of exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(11): 1357-1360. doi: 10.7507/1007-9424.201705068 Copy

1.	劉子旭, 曹遷, 凌曉鋒. 肝內膽管結石病治療進展. 實用醫學雜志, 2016, 32(4): 513-515.
2.	夏志超, 曾仲, 黃漢飛, 等. " 七步斷肝法”在腹腔鏡肝左外葉切除術中的臨床應用. 實用醫學雜志, 2016, 32(17): 2942-2943.
3.	呂立升, 魏妙艷, 湯朝暉. 肝膽管結石成因及分型. 中國實用外科雜志, 2016, 36(3): 348-350.
4.	何小東, 劉喬飛. 肝膽管結石病的診斷與治療. 中華消化外科雜志, 2015, 14(4): 275-279.
5.	殷曉煜. 肝切除在肝膽管結石治療中的作用及地位. 中國實用外科雜志, 2016, 36(3): 278-280.
6.	任旋磊, 沙洪存, 洪曉明, 等. 腹腔鏡左半肝切除治療左肝內膽管結石. 中華普通外科雜志, 2016, 31(7): 579-581.
7.	Namgoong JM, Kim KH, Park GC, et al. Comparison of laparoscopic versus open left hemihepatectomy for left-sided hepatolithiasis. Int J Med Sci, 2014, 11(2): 127-133.
8.	Kim YK, Han HS, Yoon YS, et al. Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment. World J Surg, 2015, 39(5): 1224-1230.
9.	Lin CC, Lin PY, Ko CJ, et al. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg, 2013, 83(12): 978-984.
10.	彭沙沙, 黃漢飛, 段鍵, 等. 膽囊結石繼發膽總管結石行膽道探查一期縫合125例. 中國普通外科雜志, 2014, 23(8): 1126-1128.
11.	周文星, 呂傳新, 宋超, 等. 消化液收集回輸對腸內營養支持治療患者的影響. 廣東醫學, 2014, 35(21): 3359-3361.
12.	陳永標, 池小斌, 江藝, 等. 腹腔鏡肝切除聯合膽道鏡治療肝內外膽管結石 36 例. 中國微創外科雜志, 2016, 16(9): 777-779.
13.	Catena M, Aldrighetti L, Finazzi R, et al. Treatment of non-endemic hepatolithiasis in a Western country. The role of hepatic resection. Ann R Coll Surg Engl, 2006, 88(4): 383-389.
14.	Borzellino G, Ruzzenente A, Minicozzi AM, et al. Laparoscopic hepatic resection. Surg Endosc, 2006, 20(5): 787-790.
15.	Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
16.	El-Geidie AA. Is the use of T-tube necessary after laparoscopic choledochotomy? J Gastrointest Surg, 2010, 14(5): 844-848.
17.	宋戈, 王海久, 李曉龍, 等. 肝癌患者臨床營養評價方法及其進展. 中國普外基礎與臨床雜志, 2017, 24(6): 760-764.
18.	孫曉東, 孫大偉, 王廣義. 微創技術在肝膽管結石診治中應用進展. 中國實用外科雜志, 2016, 36(3): 337-340.
19.	Peng L, Xiao J, Liu Z, et al. Laparoscopic left-sided hepatectomy for the treatment of hepatolithiasis: A comparative study with open approach. Int J Surg, 2017, 40: 117-123.

1. 劉子旭, 曹遷, 凌曉鋒. 肝內膽管結石病治療進展. 實用醫學雜志, 2016, 32(4): 513-515.
2. 夏志超, 曾仲, 黃漢飛, 等. " 七步斷肝法”在腹腔鏡肝左外葉切除術中的臨床應用. 實用醫學雜志, 2016, 32(17): 2942-2943.
3. 呂立升, 魏妙艷, 湯朝暉. 肝膽管結石成因及分型. 中國實用外科雜志, 2016, 36(3): 348-350.
4. 何小東, 劉喬飛. 肝膽管結石病的診斷與治療. 中華消化外科雜志, 2015, 14(4): 275-279.
5. 殷曉煜. 肝切除在肝膽管結石治療中的作用及地位. 中國實用外科雜志, 2016, 36(3): 278-280.
6. 任旋磊, 沙洪存, 洪曉明, 等. 腹腔鏡左半肝切除治療左肝內膽管結石. 中華普通外科雜志, 2016, 31(7): 579-581.
7. Namgoong JM, Kim KH, Park GC, et al. Comparison of laparoscopic versus open left hemihepatectomy for left-sided hepatolithiasis. Int J Med Sci, 2014, 11(2): 127-133.
8. Kim YK, Han HS, Yoon YS, et al. Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment. World J Surg, 2015, 39(5): 1224-1230.
9. Lin CC, Lin PY, Ko CJ, et al. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg, 2013, 83(12): 978-984.
10. 彭沙沙, 黃漢飛, 段鍵, 等. 膽囊結石繼發膽總管結石行膽道探查一期縫合125例. 中國普通外科雜志, 2014, 23(8): 1126-1128.
11. 周文星, 呂傳新, 宋超, 等. 消化液收集回輸對腸內營養支持治療患者的影響. 廣東醫學, 2014, 35(21): 3359-3361.
12. 陳永標, 池小斌, 江藝, 等. 腹腔鏡肝切除聯合膽道鏡治療肝內外膽管結石 36 例. 中國微創外科雜志, 2016, 16(9): 777-779.
13. Catena M, Aldrighetti L, Finazzi R, et al. Treatment of non-endemic hepatolithiasis in a Western country. The role of hepatic resection. Ann R Coll Surg Engl, 2006, 88(4): 383-389.
14. Borzellino G, Ruzzenente A, Minicozzi AM, et al. Laparoscopic hepatic resection. Surg Endosc, 2006, 20(5): 787-790.
15. Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
16. El-Geidie AA. Is the use of T-tube necessary after laparoscopic choledochotomy? J Gastrointest Surg, 2010, 14(5): 844-848.
17. 宋戈, 王海久, 李曉龍, 等. 肝癌患者臨床營養評價方法及其進展. 中國普外基礎與臨床雜志, 2017, 24(6): 760-764.
18. 孫曉東, 孫大偉, 王廣義. 微創技術在肝膽管結石診治中應用進展. 中國實用外科雜志, 2016, 36(3): 337-340.
19. Peng L, Xiao J, Liu Z, et al. Laparoscopic left-sided hepatectomy for the treatment of hepatolithiasis: A comparative study with open approach. Int J Surg, 2017, 40: 117-123.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical study of exploration and removal of stones through choledochoscope via hepatic cross-section during laparoscopic left lateral hepatectomy for hepatolithiasis

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