Abstract: Objective:To investigate the efficacy of reoperation by laparoscopy and choledochoscopy for the treatment of extrahepatic bile duct stones.
Methods:The clinical data of 41 patients with extrahepatic bile duct stones who were admitted to the Southwest Hospital of Third Military Medical University from September 2009 to December 2011 were retrospectively analyzed. Of the 41 patients, 30 were with multiple choledocholithiasis, 11 were with choledocholithiasis combined with retained calculus of the gall bladder and cystic duct. Twenty three patients received previous upper abdominal surgery for once, and 18 patients for twice or thrice. All patients underwent reoperation by laparoscopy and choledochoscopy. Patients were followed up via phone call till June 2012.
Results:Reoperation by laparoscopy and choledochoscopy was successfully done on 39 patients, with the success rate of 95.1%(39/41). Two patients were converted to open surgery due to cholangiostenosis or adhesion. The mean volume of blood loss was (33±10) mL, and the mean operation time was (150±39)minutes. The mean time for gastrointestinal function recovery was 2 days, and the postoperative hospital stay was (6.5± 2.5)days. All patients were cured without severe complications. All patients were followed up for 7 months (range, 2-27 months), and no residual bile duct stones or recurrence were found.
Conclusion:Reoperation by laparoscopy and choledochoscopy for the treatment of extrahepatic bile duct stones is effective with advanteges of minimal trauma, quick recovery and fewer complications.