Treament by laparoscopy, choledochoscopy, dilatable catheter, T tube and plastic biliary stent drainage on the left lateral lobe hepatic duct and common bile duct stones: a report of 17 cases

Abstract

Objective To explore the surgical technique and clinical effect of laparoscopy, choledochoscopy, dilatable catheter, T tube and plastic biliary stent drainage (LCDTS) for the treatment of the left lateral lobe hepatic duct and common bile duct stones. Methods The clinical data of 17 cases of the left lateral lobe hepatic duct and common bile duct stones treated with LCDTS were analyzed retrospectively from April 2002 to September 2017 in the Second People’s Hospital of Chengdu. Results Laparoscopic hepatic left lateral lobectomy and common bile duct exploration was proformed in all the 17 cases, laparoscopic cholecystectomy was proformed in 12 cases. Through the duct incision with choledochoscopy to remove gallstones, step by step dilatable catheter expanded left hepatic duct and duodenal papilla and indwelling T tube and plastic biliary stent drainage of left hepatic duct was proformed in 9 cases; push the stones into the common hepatic duct and indwelling T tube and plastic biliary stent drainage of left hepatic duct was proformed in 4 cases; step by step dilatable catheter combining balloon catheter expanded left hepatic duct and duodenal papilla and indwelling T tube and plastic biliary stent drainage of left hepatic duct was proformed in 2 cases; through choledochoscopic examination indwelling T tube and plastic biliary stent drainage of left hepatic duct due to residual stone and stenosis of the intrahepatic bile duct was proformed in 2 cases. Residual stone was occurred after T tube and plastic biliary stent drainage in 2 cases. Bile leakage was found in 1 case. No cases of perforation of intestine and bile duct, bleeding, acute pancreatitis were found. No cases of perioperative reoperation and death were found. The total postoperative complication formation rate was in 17.6%. Conclusion If patients are suitable, LCDTS for treatment of the left lateral lobe hepatic duct stones and common bile duct stones is safe and effective. Key words: Calculi; Laparoscopes; Dilatation