One Surgery Solves Two Major Problems, Hospital Stay Halved! New Approach to Gallstone Treatment

Recently, the Department of General Surgery at HeYou Hospital successfully performed another laparoscopic combined with ultra-fine choledochoscopic transcystic common bile duct exploration and stone removal, providing a safer, more precise, and minimally invasive treatment option for gallstone patients.

The team during surgery

Ms. Zhang, a 50-year-old patient, was admitted to the Department of General Surgery at HeYou Hospital as an emergency due to sudden abdominal pain at night. After detailed examination, she was diagnosed with distal common bile duct stones and gallbladder stones.

Gallbladder stones combined with common bile duct stones are a common disease of the biliary system. There are two main traditional surgical approaches:

① Laparoscopic common bile duct exploration and stone removal + T-tube drainage + Laparoscopic cholecystectomy. This procedure requires opening the common bile duct, and the long-term (6-week) indwelling T-tube postoperatively affects the patient's normal life.

② ERCP + Laparoscopic cholecystectomy. This procedure requires incising the duodenal papilla, which can easily lead to retrograde infection of the common bile duct, and also carries risks of bleeding, iatrogenic pancreatitis, and high costs.

Educational Corner

Q: What is a T-tube? Why does it affect quality of life?

A: A T-tube is a silicone or rubber drainage tube shaped like the letter "T". The short arm is placed inside the common bile duct, and the long arm exits the abdominal wall to connect to an external drainage bag.

Patients typically need to retain it for 4-6 weeks postoperatively, which affects bathing, exercise, and social activities. Improper care can also easily lead to local infection or T-tube dislodgement.

Under the guidance of Department Director Professor Li Jun, the team led by Associate Chief Physician Wang Xiangfei conducted a detailed evaluation and decided to use the "Dual-Endoscope Combined Ultra-Minimally Invasive" technique to solve both problems for the patient in a single procedure.

Left monitor shows the postoperative bile duct view, free of stones

Surgical Highlights

① 3D Ultra-High Definition Laparoscopic Precise Cholecystectomy: Utilizing 3D mode, the surgical image is clearer and more stereoscopic, allowing for more precise surgical maneuvers, reducing blood loss and the risk of bile duct injury.

② Ultra-Fine Choledochoscopic Atraumatic Stone Removal: Using an ultra-fine choledochoscope with a diameter of only 2.5mm, it enters the common bile duct via the cystic duct to complete exploration and stone removal without any damage to the common bile duct.

③ Ultra-Minimally Invasive: No need to incise the common bile duct, avoiding the need for an indwelling T-tube after traditional surgery, significantly reducing trauma and complications.

Patient Benefits

Minimal Trauma: Only 3-4 surgical incisions of 10mm, no incision on the common bile duct, eliminating the risk of postoperative bile leakage or common bile duct stricture.

Rapid Recovery: Patients can eat and ambulate immediately after regaining consciousness from anesthesia, and can be discharged 3 days postoperatively, avoiding the need for an indwelling T-tube (6 weeks). Hospital stay is halved, and total treatment time is reduced by more than two-thirds.

Single Solution: One anesthesia, one surgery, simultaneously resolves gallbladder and common bile duct stones, avoiding a second surgery and financial burden, and reducing family caregiving time.