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The Clinical Research on Dilation of Common Bile Duct after Laparoscopic Cholecystectomy

Author: ZhangLei
Tutor: HuSanYuan
School: Shandong University
Course: General Surgery
Keywords: laparoscopic Cholecystectomy (LC) Complications Expansion of common bile duct Prevention
CLC: R657.4
Type: Master's thesis
Year: 2009
Downloads: 90
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Abstract


Objective:Study diameter changes of common bile duct after laparoscopic cholecystectomy.Analysize the causes,treatment and prevention of compensatory dilation of common bile duct.Methods:The patients with preoperative and postoperative data of 150 cases after LC from January 2008 to May 2008 were collected from Qilu-Hospital of Shandong University.Postoperative follow-up ranging from 15 to 180 days,B-ultrasonic examination by B-ultrasonic was made after LC. The mean of measured data were compared by the use of t test.P＜0.05 defined as significant difference.Results:1.150cases of patients lost 20 cases,six cases of postoperative clinical symptoms of mild B-prompted the expansion of common bile duct, are not included in statistical analysis.Four cases of bile duct expansion compensatory physiological were healed without special treatment,accounting for 3.07%.1 cases of common bile duct stones, Accounting for 0.77%,the common bile duct stones was cured after T-tube drainage.1 cases of Oddis sphincter dysfunction,was cured by EST, accounting for 0.77%. 2.CBD diameter of 124 patients without obvious symptoms and normal preoperative CBD diameter were recorded at different times of the changes. CBD in diameter began to increase after two weeks,this increase continued until after 3 months.3 months after the CBD was not vary much in diameter. Preoperative CBD average diameter of 5.3mm after for the 5.9mm,by statistical analysis,the difference was significant(P＜0.01),but the CBD diameter was still within the normal range.3.Ultrasound in 86 cases after review found that after 2 to 3 months was significantly less than the diameter of the CBD after 15 to 30 days to expand.And after 3 to 6 months of the CBD was little change in diameter, 20 cases of 3 ultrasound review also found the same.This prompted cholecystectomy 3 months later is no longer the expansion of CBD diameter.Conclusions:1.CBD after cholecystectomy in diameter began to increase after two weeks,this increase continued until 3 months after operation.After 3 months after the CBD was not vary much in diameter.But the CBD diameter was still within the normal range.2.The expansion of the common bile duct leading to clinical symptoms has variety of reasons.Corresponding further treatment should be given according to physiological and compensatory expansion of bile duct, injury,residual gallstone,stone recurrence,biliary tract infection, Oddis sphincter disease.

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Gallbladder, bile duct
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