The old man’s bile duct stubborn stone was successfully crushed by lumpectomyPublished: 2015-3-19 Read: 255 times Recently, the Department of Hepatobiliary Surgery of our hospital successfully performed the second-stage biliary surgery under laparoscopy for Grandma Liu, who was over 70 years old, solving the old man’s “big problem”. The grandmother had undergone cholecystectomy 23 years ago due to severe abdominal pain in an emergency in a foreign province, leaving a scar of about 20cm on her abdomen. Recently, she had frequent abdominal pains and was told that she had residual gallbladder stones with bile duct stones in her home hospital. When they learned that our director Chen Zhong has rich experience in hepatobiliary surgery, Liu’s family came to our hospital with high hopes, and Chen took over this “hot potato”. After many discussions, Chen Zhong’s group of doctors from the Hepatobiliary Surgery Department of Nantong University Hospital made a careful surgical plan. We believe that the patient is 72 years old, very afraid of surgery, if the open abdomen treatment, not only bring her a lot of trauma, but also prone to incisional infection, intestinal adhesions, intestinal obstruction and other complications. At the same time, lumpectomy has been a no-go area in the past for the first time for open surgery with a small residual gallbladder requiring second-stage biliary surgery. Because after open surgery, the general intra-abdominal adhesions are serious, which makes the establishment of pneumoperitoneum, placement of poke card, separation of intra-abdominal adhesions, and exposure of common bile duct extremely difficult, while laparoscopic incision, stone extraction, and suturing of common bile duct put forward higher requirements for the surgeon’s technique. In the end, in order to make Grandma Liu less traumatic and recover as soon as possible, Director Chen decided to face the problem head-on and perform laparoscopic surgery. On March 12, Dr. Chen Zhong, chief surgeon, Dr. Tang Weidong and Dr. Chang Renan, deputy chief surgeon, and Dr. Zhu Li and Dr. Zhang Yu successfully performed “laparoscopic residual cholecystectomy, common bile duct exploration + intraoperative choledochoscopic lithotripsy and T-tube drainage” on Grandma Liu, breaking up a 2cm×2cm stone and removing more than 10 small stones. The operation was performed to break up a 2cm×2cm stone into more than ten small stones. According to Dr. Chang Renan, the operation lasted three hours, and everyone faced several tests. First of all, the open surgery 23 years ago had a residual gallbladder, which means that the local anatomy was quite complicated at that time; secondly, the abdominal cavity of Grandma Liu had extensive adhesions, and it took more than an hour just to separate the abdominal adhesions and find the anatomical location of the residual small gallbladder and bile ducts; furthermore, when the bile ducts were cut open, high tension yellow-green purulent bile gushed out, and it took several times of cleaning to obtain a clearer surgical field and distinguish The problem was that the bile duct structure was thin and the stone was stuck in the lower part of the bile duct, which could be retrieved with a mesh basket, but the stone was embedded, so the mesh basket could not be retrieved at all. “After locating the stone, he adjusted the orientation of the lithotripter wire and carefully lithotripped the stone in the center. After several rounds of lithotripsy, flushing, re-lithotripsy and re-flushing, the embedded stone was slowly “compromised” and completely removed. After the successful surgery, the family was so grateful that a relative broke the news that they had sent a red packet to Director Chen Zhong before the surgery, but it was returned. They were uneasy at first and quietly asked the patients in the same ward, and got the same answer: “Director Chen refused to accept the red packet, and the knife was opened so well, what a good doctor!” Hearing such comments, even though the surgery had not yet taken place, the whole family was already half relieved. People who are familiar with Director Chen know that when he operates on patients, he tries his best to meet the patients’ requests for surgery time, and it is not uncommon for him to give up his rest to operate. The hepatobiliary surgery ward is full of thank you letters, Chen Zhong director’s name is the most photographed. Huang Lin