Micro-wound operation is becoming the trend in surgery in the 21st century and laparoscopic surgery is regarded as an important component of micro-wound surgery. In operations combining laparoscopic hepatic left lateral lobectomy with fiber choledochoscopic exploration of the common bile duct, the much shorter incision required lessens the post-operative pain of patients and the elimination of a need for T-piece drainage also markedly reduces post-operative complications such as biliary fistula, cholangitic stenosis, biliary tract bleeding, electrolytical or digestive unbalance and local infections.

At the same time the liver function damage of the laparoscopic group is much more mild than in the traditional open operation group. These findings show that laparoscopic and choledochoscopic exploration hold many advantages over traditional open operations.

A research article to be published on February 21, 2008 in the World Journal of Gastroenterology addresses this question.

The research team led by Dr. Kun Zhang from Fu Zhou General Hospital performed laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct and found that this kind of operation could markedly lessen the post-operative pain of patients and reduce post-operative complications.

In this research, laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of common bile duct was performed in patients with gallstones in the left lobe of liver and common bile duct. Ligments of livers were dissociated by laparoscopic instruments under pneumoperitoneum conditions. The Trocar puncture point near the xiphoid was extended to about 5 cm. From this incision we resected the left lateral lobe of the liver and took out the calculus of the intrahepatic duct without pneumoperitoneum.

From the extended trocar incision and the left intrahepatic duct, the common bile ducts were inspected by fiber choledochoscopy for possible remnant gallstones. After the remnant gallstones were removed and the duodenal papillas were assessed as normal, we sutured the open part of the left intrahepatic duct and the left liver section.

Researchers found that laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the bile duct had many advantages over traditional open operations.

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Reference: Zhang K, Zhang SG, Jiang Y, Gao PF, Xie HY, Xie ZH. Laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct and traditional open operation. World J Gastroenterol 2008; 14(7): 1133-1136

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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