PDF(Pubmed)
Abstract：
BACKGROUND: Intrahepatic and extrahepatic lithiasis, a condition characterized by the presence of stones in the liver and bile ducts, is a common disease in Asia, particularly in East and Southeast Asia. We report a case with laparoscopic exploration of the common bile duct using a flexible cholangioscope and modified trans-common bile duct tunnel for hepatolithiasis combined with the dilated common bile duct.
METHODS: A 35-year-old male patient has had chronic epigastric and right upper quadrant pain. The common bile duct was 11 mm dilated, and hepatolithiasis was also present, according to an upper abdomen MRI. The largest stone measured between 14 and 21 mm. A modified trans-common bile duct tunnel from the abdominal wall into the common bile duct was used in a laparoscopic procedure to examine the common bile duct. Complications during the procedure or following it were not present. The procedure took 120 min, and the blood loss was about 50 ml. The patient was discharged on the sixth postoperative day, and a follow-up visit one month later revealed that single-session stone clearance had been accomplished.
CONCLUSIONS: Laparoscopic exploration of the common bile duct using a cholangioscope and modified trans-choledochal tube is applicable in selected patients and can be effectively and safely used to treat hepatolithiasis combined with the dilated common bile duct.
CONCLUSIONS: In this case, we present an innovative approach for hepatolithiasis when combined with dilated common bile duct.
METHODS: A 35-year-old male patient has had chronic epigastric and right upper quadrant pain. The common bile duct was 11 mm dilated, and hepatolithiasis was also present, according to an upper abdomen MRI. The largest stone measured between 14 and 21 mm. A modified trans-common bile duct tunnel from the abdominal wall into the common bile duct was used in a laparoscopic procedure to examine the common bile duct. Complications during the procedure or following it were not present. The procedure took 120 min, and the blood loss was about 50 ml. The patient was discharged on the sixth postoperative day, and a follow-up visit one month later revealed that single-session stone clearance had been accomplished.
CONCLUSIONS: Laparoscopic exploration of the common bile duct using a cholangioscope and modified trans-choledochal tube is applicable in selected patients and can be effectively and safely used to treat hepatolithiasis combined with the dilated common bile duct.
CONCLUSIONS: In this case, we present an innovative approach for hepatolithiasis when combined with dilated common bile duct.
摘要：
背景：肝内和肝外结石，一种以肝脏和胆管中存在结石为特征的疾病，是亚洲的常见病,特别是在东亚和东南亚。我们报告了使用柔性胆道镜和改良的经胆总管隧道腹腔镜探查胆总管的病例，用于肝胆管结石合并胆总管扩张。
方法：一名35岁男性患者患有慢性上腹部和右上腹疼痛。胆总管扩张11mm,肝胆管结石也出现了，根据上腹部MRI。最大的石头测量在14到21毫米之间。在腹腔镜手术中使用了从腹壁到胆总管的改良的经胆总管隧道来检查胆总管。术中或术后未出现并发症。这个过程花了120分钟，失血量约为50毫升。病人在术后第六天出院,一个月后的后续访问显示，一次会议的石块清理已经完成。
结论：腹腔镜下胆总管探查术适用于部分患者，可安全有效地治疗胆总管扩张型肝胆管结石。
结论：在这种情况下，当合并扩张的胆总管时，我们提出了一种针对肝胆管结石的创新方法。
方法：一名35岁男性患者患有慢性上腹部和右上腹疼痛。胆总管扩张11mm,肝胆管结石也出现了，根据上腹部MRI。最大的石头测量在14到21毫米之间。在腹腔镜手术中使用了从腹壁到胆总管的改良的经胆总管隧道来检查胆总管。术中或术后未出现并发症。这个过程花了120分钟，失血量约为50毫升。病人在术后第六天出院,一个月后的后续访问显示，一次会议的石块清理已经完成。
结论：腹腔镜下胆总管探查术适用于部分患者，可安全有效地治疗胆总管扩张型肝胆管结石。
结论：在这种情况下，当合并扩张的胆总管时，我们提出了一种针对肝胆管结石的创新方法。
