The Laparoscopy, Choledochoscopy, Duodenoscopy, Step by Step Dilatable Catheter, the Small Incision of Papillary Sphincterotomy, T Tube + Double Biliary Catheter Bundling and Supporting Drainage for Treatment of the Left Lateral Lobe Hepatic Duct and Common Bile Duct Stones during the Course of Therapeutic Laparoscopy: A Report of 15 Cases

Abstract

Objective: To explore the surgical technique and clinical effect of laparoscopy, choledochoscopy, duodenoscopy, step by step dilatable catheter, the small incision of papillary sphincterotomy, T tube + double biliary catheter bundling and supporting drainage (LCTBS) of the corresponding period for the treatment of the left lateral lobe hepatic duct and common bile duct stones during the course of therapeutic laparoscopy. Methods: The clinical data of 15 cases of the left lateral lobe hepatic duct and common bile duct stones undergoing LCTBS were analyzed retrospectively from December 2005 to September 2018 in the Second People’s Hospital of Chengdu. Results: It was in 15 cases removed the left hepatic lateral lobe and exploration of common bile duct, in 7 cases re-moved the gallbladder by laparoscopy. Through step by step dilatable catheter expanded left he-patic duct and duodenal papilla, the small incision of papillary sphincterotomy, indwelling T tube + double biliary catheter drainage of duodenal papilla was in 73.3% (11/15). Through step by step dilatable catheter expanded duodenal papilla, the small incision of papillary sphincterotomy, in-dwelling T tube + double biliary catheter drainage of duodenal papilla was in 20.0% (3/15). Through step by step dilatable catheter expanded left hepatic duct, left hepatic duct plastic surgery, the liver round ligament repairing the defect, indwelling T tube and double biliary catheter drainage of left hepatic duct was in 6.7% (1/15). Residual stone of the left medial lobe hepatic duct occurred in one case (6.7%). Bile leakage occurred in one case (6.7%). No cases had perforation of intestine and bile duct, bleeding, acute pancreatitis. No perioperative reoperation and death. Total postoperative complication formation rate was 13.3% (2/15). Conclusion: From preliminary results of limited cases in our hospital, if patients are suitable, LCTBS for treatment of the left lateral lobe hepatic duct stones and common bile duct stones is safe and effective.