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Instrumental detection of cystic duct stones during laparoscopic cholecystectomy

Hepatobiliary & Pancreatic diseases International 2014年第2期13卷 215-218页

作者： Amir Kambal Tomos Richards Harsha Jayamanne Zeyed Sallami Ashraf Rasheed Taha Lazim Gwent Institute for Minimal Access Surgery Royal Gwent Hospital

Residual cystic duct stones (CDSs) after cholecystectomy have been recognized as a cause of post cholecystectomy pain. This study was undertaken to determine the incidence of CDSs during laparoscopic cholecystectomy(LC). A cohort of 330 consecutive patients (80 males and 250females) undergoing LC between November 2006 and May2010 was studied. Their age ranged between 16 and 88 years(median 50, IQR: 36.62). The data were prospectively collected of preoperative liver function tests, imaging, the presence of intraoperative CDSs, and common bile duct stones at on-table cholangiogram. CDSs were detected intraoperatively in 64 of the 330 patients (19%). Ultrasound failed to detect CDSs in any of these cases. Deranged liver function tests were noted in 73% of the patients with CDSs and in 57% without CDSs Common bile duct stones were detected in 9% (29) of the 330patients. CDSs occur commonly at routine cholecystectomy, and preoperative investigations are not helpful in their diagnosis As CDSs may lead to postoperative morbidity, they should be actively sought out during surgery if present.

关键词： biliary tract diseases laparoscopic cholecystectomy complications cystic duct stones gallstone diseases

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