The Cause And Reoperation Of Bile Duct Stones

Objective: To analyze and find the solution to reparation of Cholelithiasis for reducing the rate of reoperation.Methods: Retrospective analysis was performed on 81 patients with reoperation of Cholelithiasis during the last ten years. By analyzing the relation of reoperation with the first method of surgery and the cause of reoperation, put forward the experience of reoperation and how to prevent from.Results: The clinical data of 81 cases were analyzed retrospectively, who included 35 men and 46 women for Cholelithiasis operated in the last 10 years. The median age 4 9 . 5 years (range25-74). The recurrent and residual bile stone spot: intrahepatic stones 30 cases, the common bile duct stones 16 cases, the Stricture and calculi after Cholangio-jejunal anastomosis of Roux-en-Y 6 cases, the reflux cholangitis after Choledochoduodenostomy 3 cases.71 patients (88%) received operation twice and 10 patients(12%) underwent 3 operations,2 cases(2.5%) died of septic shock postoperatively. there are 42 cases from the outer court extension.Conclusions: The causes of reoperation were: the stone were residual because the operation were undergone in patients accompanied acute bancreatitis or acute cholangitis, the stones were residual because of the inappropriate surgery method were undergone, the requirement of medical treatment is imperfect. The measures of preventing reparation: avoiding emergency operation. Individual treatment should be performed according with eradicating obstruction, removing focus and appropriate drainage. The hepatic stones can be removed together with the pathologic bile ducts and liver atrophy, thus reducing the risk of recurrent intrahepatic stones. Intrahepatic bile duct constriction was very important .Hepatectomy should be performed for primary intrahepatic stones. Intraopertive or postoperative cholangioscopy is also an effective measurement during the operation; it can markedly decrease the incidence of residual stones. The accurate preoperative and operative diagnosis of the stones. Distribution and stricture degree of bile duct were important. The emphases of reoperation were the exposure of hepatic portal duct. Postoperative traditional Chinese medicines notably decrease postoperative residual and recurrent stones.