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| Efficacy and Safety of Percutaneous Transhepatic Choledochoscopy in the Treatment of Intrahepatic and Extrahepatic Bile Duct Stones |
| GONG Yiwei, OU Junjie, PENG Chengdong, et al |
| The People's Hospital of Wuzhou, Guangxi Wuzhou 543000, China |
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Abstract Objective: To investigate the efficacy and safety of percutaneous transhepatic choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones. Method: The clinical data of 92 patients with intrahepatic and extrahepatic biliary calculi in our hospital were retrospectively analyzed. Among them, 32 cases underwent percutaneous transhepatic choledochoscopy (observation group), 60 cases underwent conventional common bile duct lithotomy and T tube drainage (control group). The clinical efficacy (stone clearance rate, postoperative stone recurrence rate), operative related indexes (operation time, intraoperative bleeding, incision length, postoperative exhaust time, fasting time, hospitalization time), postoperative rehabilitation indexes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (STB)], liver function indexes and postoperative complications were compared between the two groups. Results: There was no significant difference in stone removal rate and postoperative stone recurrence rate between the two groups (P > 0.05). The operation time, intraoperative bleeding, incision length, postoperative exhaust time and fasting time in the observation group were significantly lower than those in the control group (P<0.05). The postoperative ALT, AST and STB of the two groups were significantly lower than those before operation (P<0.05), but there was no significant difference between the two groups in liver function index (P>0.05). The incidence of complications in the observation group was lower than that in the control group, the difference was statistically significant (P<0.05). Conclusion: Percutaneous transhepatic choledochoscopy and traditional surgery are effective in the treatment of intrahepatic and extrahepatic bile duct stones, and can improve the liver function of patients. But the former has the advantages of minimally invasive, less trauma, rapid postoperative recovery, low incidence of complications, and has more clinical value.
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[1] 王锋.精准肝脏切除用于肝胆管结石病对结石残留的影响分析[J].广西医科大学学报,2016,33(2):348~349.
[2] 吴荣寿,邬林泉,殷香保,等.单纯切除病变胆管分支治疗右肝区域性胆管结石的疗效分析[J].中国普通外科杂志,2015,24(8):1077~1082.
[3] 龚根强,李勃,党新文,等.慢性肝炎患者胆结石发生率及危险因素研究[J].陕西医学杂志,2016,45(4):436~437.
[4] 李清军,汤晓强,杨文亮.经皮经肝胆道镜对原发性肝内胆管结石的疗效评价[J].肝胆胰外科杂志,2015,27(4):292~294.
[5] Ryu D G,Choi C W,Kang D H,et al.Predictive Factors of Beyond ExpandedIndication of Endoscopic Submucosal Dissection in Early GastricCancer[J].Gastroenterology,2017,152(5):S258~S259.
[6] Wang P,Sun B,Huang B,et al.Comparison between percutaneous transhepatic rigid cholangioscopic lithotripsy and conventional percutaneous transhepatic cholangioscopic surgery for hepatolithiasis treatment[J].Surgical LaparoscopyEndoscopy&Percutaneous Techniques,2016,26(1):54.
[7] 徐恕,张剑权,符国珍,等.经皮肝穿刺胆管造瘘电子胆道镜取石术治疗肝内胆管结石的近远期疗效[J].中华普通外科杂志,2016,31(3):212~214.
[8] 张建,李晓辉,卢智略,等.经皮肝胆道造瘘硬性胆道镜一步法碎石取石与传统腹腔镜治疗肝内胆管结石疗效比较[J].海南医学,2016,27(21):3496~3498.
[9] 符真,张剑权,周帅.胆道镜经皮肝穿刺胆道造瘘取石治疗肝内胆管结石42例临床分析[J].中国现代医学杂志,2017,27(13):127~128. |
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2018, Vol. 24 
