Common bile duct stones are stones located in the common bile duct, which usually includes all stones in the extrahepatic bile duct. Unlike gallbladder stones, common bile duct stones require an attempt to remove the stones regardless of the presence or absence of symptoms. One of the most effective methods is surgical removal of stones from the common bile duct. Since common bile duct stones are often accompanied by gallbladder stones, the gallbladder can be removed at the same time. The traditional surgical method of removing stones from the common bile duct is to place a T-shaped drainage tube through the common bile duct incision, which is connected to the outside of the body, and the bile flows out of the body through the drainage tube after surgery. After the surgery, the bile flows out of the body through the drainage tube. After discharge from the hospital, the patient needs to continue to carry the drainage tube until more than 3 weeks after the surgery. There is a risk of accidental detachment during the period of carrying the tube, and it can also cause severe biliary peritonitis when the tube is removed.
With the development of minimally invasive technology, in recent years, the technique of simultaneous laparoscopic cholecystectomy and common bile duct extraction has been developed and matured. The Hepatobiliary Surgery Department of the Ningxia Autonomous Region People’s Hospital further improved this technique by placing an internal stent in the common bile duct to drain the bile duct after the choledochotomy and removing the stone, while closing the choledochotomy incision in one stage with sutures. All 120 patients treated with this method were successfully discharged from the hospital, and the patients were treated as if they had undergone a relatively simple laparoscopic cholecystectomy after the operation. The surgically placed endoprosthesis was automatically expelled with feces 2 weeks after surgery. This technology is the first of its kind in China and the leading one in the world. The upper picture shows the stent drainage followed by one-stage suturing of the bile duct incision, and the lower picture shows the T-tube drainage from the bile duct incision. Tian Mingguo, Department of Hepatobiliary Surgery, Ningxia Hui Autonomous Region People’s Hospital