Laparoscopic duodenal papilla step by step dilatable catheter dilatation of transabdominal consequent guidance technology: a report of 253 cases

Objective To explore the surgical technique and clinical effect of laparoscopic duodenal papilla step by step dilatable catheter dilatation of transabdominal consequent guidance technology (LPCD) for treatment of extrahepatic bile duct stones or the obstruction of papillary during the course of laparoscopic common bile duct exploration. Methods The clinical data of 253 patients met the criteria from October 1998 to May 2017 were retrospectively analyzed. Results Successful laparoscopic cholecystectomy was proformed in all the 253 cases. Laparoscopic duodenal papilla step by step dilatable catheter dilatation with primary suture was proformed in 223 cases. T-tube was indwelled in 16 cases for common bile duct stricture or residual gallstones. 8 cases were converted to intraoperative ERCP and ENBD. 3 cases were converted into open surgery. Common bile duct exploration was given up in 3 cases. Residual gallstones after primary suture was found in 1 cases. Bile leakage was found in 17 cases.Mild pancreatitis was found in 5 cases. No Intestinal perforation, bile duct complications such as perforation, bleeding, severe pancreatitis, perioperative reoperation, and death cases were found. The total complication rate was 10.3%. Conclusion From our preliminary and limited study, we found that if the case permitted, laparoscopic duodenal papilla step by step dilatable catheter dilatation of transabdominal consequent guidance technology is feasible, effective and safe for treatment of extrahepatic bile duct stones or the obstruction of papillary during the course of laparoscopic common bile duct exploration. Key words: Cholelithiasis; Laparoscopes; Cholestasis; Dilatation