Bile Duct Stones and Their Hazards Bile duct stones, as the name implies, are stones located in the bile ducts inside and outside the liver, which is a common type of gallstones commonly referred to as gallstones. In recent years, with the change of people’s dietary structure and lifestyle, the incidence of gallstone disease, including common bile duct stones, has increased year by year. According to statistics, the incidence of bile duct stones accounts for 20-40% of all gallstone patients in China (due to regional differences in dietary structure). Patients with bile duct stones often suffer from severe pain in the right upper abdomen induced by eating greasy food, high fever and jaundice, and can induce fatal and serious complications such as acute obstructive purulent cholangitis, biliary acute pancreatitis, toxic shock, etc., which can lead to death in serious cases. Long-term recurrent attacks of the disease, repeated stimulation of stones and inflammation may also lead to the occurrence of bile duct cancer, so bile duct stones must be given sufficient attention. Classical bile duct stone surgery In the past, for patients suffering from bile duct stones, open surgery was mostly adopted. Specifically, the common bile duct is incised in the open abdomen, and the stone is slowly removed from the bile duct with lithotripter, and then cholangiography is performed to confirm that the stone is removed. Not only the incision is large, but also the operation of stone extraction with lithotripter depends on the doctor’s hand and experience, and cannot be seen directly. In addition, T-tube drainage takes a long time, causing much inconvenience and pain to the patient. What is minimally invasive choledochoscopy? Minimally invasive choledochoscopy is one of the most advanced biliary surgeries in the world. With the help of high-tech products laparoscope and choledochoscope, a pneumoperitoneum needle is first used to puncture through the abdomen for inflation, then a laparoscope is placed to explore the condition of the gallbladder and bile ducts, and depending on the condition, it is decided whether to remove the gallbladder at the same time. If stones are identified in the bile duct, an incision of approximately 0.5
If stones are identified in the bile duct, a 0.5 cm incision is made in the anterior wall of the common bile duct and a choledochoscope is inserted, while saline is placed to flush and observe. Finally, the upper hepatic duct and the lower common bile duct are repeatedly examined with the choledochoscope until the opening of the bile duct into the duodenum. After determining that there are no residual stones, the common bile duct incision can be closed in one stage depending on the inflammation and diameter of the duct. If a T-tube must be placed, the tube can be led directly through the laparoscopic poke without a separate opening. Advantages of minimally invasive treatment of bile duct stones Compared with conventional open surgery, the minimally invasive choledochoscopic surgical treatment method now carried out has many advantages: 1. There are even sequelae such as incisional hernia. During laparoscopic surgery, there are only 3~4 puncture holes in the abdominal wall, the longest one is only 1cm long and the shortest one is only 0.5Cm, which can be healed without suturing. So there is no conspicuous incision scars, some patients 3 months after surgery, the abdominal wall can not even find any trace. 2, not easy to damage internal organs: in laparoscopic surgery, high-definition laparoscopy can magnify the observed object 5~15 times, and its clarity is much higher than that of open surgery under the ordinary naked eye. On the TV screen, the organs in the abdominal cavity can be clearly displayed, and the situation in the bile ducts can be clearly displayed, even the tiny blood vessels can be clearly displayed, and all kinds of operations can be seen on the TV screen, which is conducive to the doctor’s patient and meticulous operation, and the probability of damaging the internal organs is greatly reduced. 3. Clean and thorough stone extraction: The biliary tractoscope can reach into the bile duct cavity for stone extraction, which is more intuitive and more thorough than the blind extraction of conventional surgery. It is also possible to observe the inflammation and other lesions in the bile duct cavity at the same time, and to take biopsy if necessary to exclude the possibility of malignant tumor. Therefore, it is said that lumpectomy technology not only extends the doctor’s arm, but also extends the doctor’s vision. 4. Light pain and fast recovery: Because of the small trauma of minimally invasive surgery, the patient’s pain is significantly reduced compared with conventional surgery. Generally, they can get out of bed 6-8 hours after surgery, and the time of eating, infusion time and hospital stay after surgery are much earlier than those of conventional surgery.