Abstract:
Objective To investigate the clinical effect of stylized laparoscopic left hemihepatectomy combined with stone extraction by percutaneous transhepatic cholangioscopy in the treatment of Left Intrahepatic Bile Duct Stones.
Methods 100 cases of left intrahepatic cholangiolithiasis treated in our hospital from January 2015 to December 2017 were retrospectively analyzed. According to the surgical methods, they were divided into laparoscopy combined choledochoscopy group (observation group, n=50) and laparotomy combined choledochoscopy group (control group, n=50). SPSS19.0 software was used for data analysis. The intraoperative and postoperative measurements were described by (±s), and compared by independent t test. Pearson χ2 test and Kruskal-Wallis test were used to compare the classified and ordered data of postoperative residual stones, complications, short-term efficacy and recurrence. P<0.05 was statistically significant.
Results There was no significant difference in the operation time between the observation group and the control group (P>0.05). The amount of bleeding, the time of ambulation after operation, the recovery time of intestinal function and the time of hospitalization in the observation group were significantly better than those in the control group (P<0.05). The levels of ALT, AST and TBIL in the observation group and the control group decreased significantly after 2 weeks of the operation, and the levels of ALT and AST in the observation group were significantly lower than those in the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that of the control group (10.0% vs. 26.0%) (P<0.05). The short-term effect of the observation group was significantly better than that of the control group (P < 0.05). There was no significant difference in the recurrence rate between two groups after 1 year of the operation (P> 0.05).
Conclusion Compared with traditional laparotomy, stylized laparoscopic left hemihepatectomy combined with stone extraction by percutaneous transhepatic cholangioscopy is safe and effective for the treatment of left intrahepatic bile duct stones. It has the advantages of quick recovery, less complications and better clinical efficacy. It has good clinical value.
Key words:
Calculi,
Bile ducts, intrahepatic,
Laparoscopes,
Hepatectomy
Zhanyang He, Qiuhong Fan. Effect of stylized laparoscopic left hemihepatectomy combined with stone extraction by percutaneous transhepatic cholangioscopy in the treatment of Left Intrahepatic Bile Duct Stones[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(05): 507-510.