摘要：Objective To explore and discuss the cause of the cystic duct remnant calculi and its relationship with cystic duct anatomic anomalies. Methods From January 2009 to January 2012, total 2 235 cases of LC were performed in our hospital and 23 cases of them were found cystic duct remnant calculi. In this study, the clinical data was collected and a retrospective analysis was used. Results A totally 63 patients with abnormal anatomy were found, among them, residual stones were found in 15 cases. Among no anatomic anomalies of 2 172 cases, residual stones were found in 8 cases. Thirty-seven cases were found with cystic duct parallel to the common hepatic duct with a low-level opening, residual stones in 8 cases; the opening at the left side of common hepatic duct was found 11 cases, residual stones in 4 cases; 9 cases with the opening at the antetheca of common hepatic duct, residual stones in 1 case; 4 cases with the opening at the parties posterior of common hepatic duct, residual stones in 1 case; 2 cases had short cystic duct, residual stones in 1 case. Emergency surgery in 105 cases, residual stones in 5 cases; muddy stone in 134 cases, residual stones in 11 cases; incarcerations at the neck of gallbladder or calculus of cystic duct were found in 213 cases, residual stones in 9 cases. Conclusion Anatomic anomalies of the cystic duct increase the difficulty of LC operation and the potential risk of remnant calculi. Correct identification and management of the abnormal anatomical cystic duct is crucial to reduce remnant calculi.%目的 探讨导致胆囊管结石残留的原因及其与胆囊管解剖异常的关系.方法 我院2009年1月至2012年1月期间施行LC术2235例,回顾性分析LC术后患者胆囊管结石残留情况.结果 2235例中共发现胆囊管解剖异常63例,结石残留15例:其中胆囊管与肝总管伴行过长远端低位汇合37例,发生结石残留8例；开口于肝总管左侧壁者11例,结石残留4例；开口于肝总管前壁9例,结石残留1例；开口于胆总管后壁4例,残留1例；胆囊管极短2例,残留1例.无解剖异常的2172例中仅8例发生结石残留.另,2235例中,急诊手术105例,发生结石残留5例；泥沙样结石134例,发生结石残留11例；颈部及胆囊管结石嵌顿213例,发生结石残留9例.结论 胆囊管解剖异常增加了LC的操作难度及胆囊管结石残留的潜在风险,正确辨认和处理解剖异常的胆囊管是减少胆囊管结石残留的关键.
