title: [Total laparoscopy to treat hepatolithiasis using gallbladder-hepatic duct subcutaneous tunnel].
abstract: To investigate the effect and feasibility of total laparoscopy to treat hepatolithiasis using gallbladder-hepatic duct subcutaneous tunnel. Retrospective analysis was conducted of the case data of 11 patients with hepatolithiasis who underwent total laparoscopic treatment using gallbladder-hepatic duct subcutaneous tunnel from January 2010 to October 2014. The operation time, blood loss, postoperative complications and recurrence of stones were recorded.All the cases completed the operation.The average hospital-stay was 9.2 days (range: 3-29 d). The average operation time was 298 min (range: 225-480 min). The average blood loss was 253 mL (range: 50-700 mL), and the average blood loss of liver resection groups was 325 mL (range: 200-700 mL). The average discharge time was 3.3 days (range: 3-5 d). The rate of postoperative residual stones was 36.4% (4/11).We extracted stones with choledochofiberscope via T-tube sinus six weeks after operation. One case developed biliary leakage, and healed through adequate drainage and the T-tube was pulled out after one month. There was no perioperative mortality. All the cases were followed up and the mean follow-up was 22 months (range: 2-51 months). The anastomotic stenosis of gallbladder-hepatic duct was found in one case. But we got a good therapeutic result with performed gallbladder chemical ablation with 95% ethanol. No recurrence of hepatolithiasis was found. As a choice for minimally invasive method to hepatolithiasis using gallbladder-hepatic duct subcutaneous tunnel,total laparoscopy is a safe and feasible procedure.
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: T
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: L
authors.initials: L
authors.lastname: Cui
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: G
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Ling
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: C S
authors.initials: CS
authors.lastname: Hou
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: L X
authors.initials: LX
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Xu
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000628:therapy; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005704:Gallbladder / Q000601:surgery; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008107:Liver Diseases / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies