Abstract:
Objective
To explore the causes and countermeasures of basket incarceration in choledochoscopy through T-tube tract lithotripsy.
Methods
Retrospective analysis of the data of 12 patients with basket incarceration during biliary tract lithotripsy after bile duct surgery from Jan. 2017 to Dec. 2019 in Hunan Provincial People′s Hospital .And the internal diameter ratio of stone bile duct at incarcerated site, stone properties, treatment methods and treatment outcomes were calculated.
Results
The diameter of stones/diameter of bile duct stenosis measured by preoperative T-tube radiography in 12 patients was all greater than 1.2 cm, and the incarcerated stones were all gallbladder pigment stones.Three patients were successfully netted after being pushed to one side by the basket, three patients were removed after using additional choledochoscopy, and the remaining six patients were removed after cutting the basket. The basket were removed from all cases, and 5 cases of biliary bleeding were rinsed with noradrenaline saline and stopped bleeding.
Conclusions
We need to pay attention to the choledochoscopy through the T-tube sinus tract for basket incarceration, preoperative T-tube angiography stone bile duct diameter ratio can predict the possibility of incarceration, and the lithotripsy is conducive to avoiding forced extraction leading to bleeding, thus ensuring the safety of surgery.
Key words:
Hepatic calculus,
Choledochoscopy for stone removal,
T-tube sinus,
Basket
Hao Bu, Yang Zhou, Wei Cheng. Choledochoscopy was used to remove stones from the T-tube sinus tract and the basket were incarcerated in 12 cases[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2020, 13(01): 54-56.