Minimally invasive surgery technology of gallbladder stones combined bile duct stones / 国际外科学杂志

ABSTRACT

While Choledocholithiasis is concomitant with gallstones in approximately 9.2％ ～ 14.3％ of the patients,and its treatment methods are mainly by surgery,including(1)Open cholecystectomy and open choledocholithotomy 、T-tube drainage (OC-OCHTD) ; (2) Endoscopic retrograde cholangiopancreatography (ERCP) and Endoscopic sphincterotomy (EST),and followed by Laparoscopic cholecystectomy (LC) second stage (ERCP/EST + LC) ; (3) Laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC +CBDE).These three methods all have their own characteristics.The last two methods are minimally invasive surgery treatment.Practice has proved that LCBDE and ERCP + EST + LC treatment methods are feasible and show certain advantages,compared with OC-OCHTD reflecting the development of minimally invasive surgery.Practice has proved that LCBDE and ERCP + EST + LC treatment methods are feasible and show certain advantages,compared with OCHTD reflecting the development of minimally invasive surgery.But the indications of operation are need to be summarized constantly in clinical practice,while operation skills are also need to be improved.At present,many reports of the two methods of minimally invasive treatment have been published because of the controversy,such as surgical indications,hospitalization expense,operation time,therapy danger,complications and the length of hospital stay.Both LCBDE and ERCP + EST + LC show some advantages and disadvantages compared with each other.On proper indications,LCBDE embodies the superiority of minimally invasive surgery technology as a one-stage operation,which is preferred for patients of choledocholithiasis with concomitant gallstones.For patients,no matter what kind of operation method,less invasion,lower risk and less complications is the key for best treatment choise.