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《Anhui Medical Journal》 2018-01
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Clinical application of laparoscopic common bile duct exploration in patients with upper abdominal surgery

TONG Chaogang;AN Dong;CHEN Xiaopeng;Department of Hepatobiliary Surgery,Chaohu Hospital Affiliated to Anhui Medical University;  
Objective To investigate the feasibility and clinical effect of laparoscopic common bile duct exploration in patients with history of upper abdominal surgery. Methods 43 patients with history of abdominal operation randomly were selected as the case group,while 60 patients without history of abdominal surgery as the control group. All patients were performed with laparoscopic common bile duct exploration during March 2014 to March 2017 of this hospital. Operation status,conversion to laparotomy,postoperative complications,residual stone rate and recurrence rate were observed and compared between the two groups. Results The intraoperative bleeding and abdominal drainage were(123. 1 ± 21. 4) m L,(121 ± 23. 3) m L in case group,which were higher than(46. 1 ± 8. 1) m L,(49. 1 ± 9. 8) m L incontrol group; and the operative time(2 ± 0. 4) h,hospitalization time(9. 3 ± 1. 5) d longer than(1. 6 ± 0. 3) h,(8. 5 ± 1. 3) d control group;the differences were statistically significant(P 0. 05). In case group,4 patients received laparotomy,and the open abdominal rate was 9.30%(4/43),while control group had one patient converted to open laparotomy,and the open abdominal rate was 1. 67%(1/60); in case group,postoperative complications appeared in three patients(6. 98%),while in two patients in control group(3. 33%); three months after surgery,no residue appeared in two groups of stones; in case group,stone recurrence occurred in three patientsafter two years(6. 98%),and in two patients in control group(3. 33%),and there were no significant differences(P 0. 05). Conclusion The effect of laparoscopic common bile duct exploration in patients with upper abdominal surgery is significant,despite a relatively high intraoperative conversion rate.The scope of clinical indications can be increased and the rate of intraoperative complications and postoperative recurrence rate do not significantly increase,soa reasonable surgical program may be chosen in clinic based on the actual situation of patients.
【Fund】: 安徽省卫生厅医学科研课题(项目编号:2010C073)
【CateGory Index】: R657.4
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