Effect of percutaneous transhepatic choledochoscopy in the treatment of complex intrahepatic and extrahepatic bile duct stones
10.3760/cma.j.cn113884-20230616-00166
- 白话标题:经皮经肝胆道镜在复杂肝内外胆管结石治疗中的应用
- 作者:
Caiming WANG
1
;
Yanpeng YAO
;
Shaozhen RUI
;
Yongjin PAN
;
Gong CHEN
;
Hui ZHANG
作者信息
1. 白银市第二人民医院普外科，白银 730900
- 关键字:
Gallstones;
Percutaneous transhepatic choledoscopy;
Liver function;
Complications
- 来源:
Chinese Journal of Hepatobiliary Surgery
2023;29(12):902-905
- 国家China
- 语言:Chinese
-
摘要:
Objective:To evaluate the curative effect of percutaneous transhepatic choledoscopy (PTCS) in the treatment of complex intrahepatic and extrahepatic bile duct stones.Methods:Clinical data of 120 patients with complex intrahepatic and extrahepatic bile duct stones admitted to Baiyin Second People's Hospital from January 2021 to December 2021 were retrospectively analyzed, including 74 males and 46 females, aged (53.3±2.4) years old. Patients were divided the control group ( n=60) who underwent routine laparotomy and the observation group ( n=60) who underwent PTCS. Perioperative outcomes, including the intraoperative blood loss, operation time, postoperative exhaust time, stress status, liver function index [serum level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] and postoperative complications of the two groups were compared. Results:Compared with the control group, the observation group had a shorter operation time [(1.62±0.24) h vs. (2.35±0.28) h] and postoperative exhaust time [(1.80±0.25) d vs. (2.53±0.28) d], and a decreased intraoperative blood loss [(51.21±8.23) ml vs. (119.21±8.29) ml] (all P<0.05). The serum levels of adrenaline [(119.7±12.0) ng/ml vs. (130.5±14.2) ng/ml], ALT [(70.02±2.42) U/L vs. (87.30±2.56) U/L] and AST [(188.6±24.7) U/L vs. (201.7±28.5) U/L] were lower in observation group one day after surgery (all P<0.05). The total effective rate in observation group was higher than that in control group [96.7%(58/60) vs. 83.3%(50/60), P=0.005]. The rate of complications was also lower in observation group [6.7%(4/60) vs. 36.7%(22/60), P=0.005]. Conclusion:Compared to routine laparotomy, PTCS could be more feasible for complex intra- and extrahepatic bile duct stones, considering its minimal invasiveness, less stress reaction, enhanced postoperative recovery, less disturbance of liver function, and decreased complications.
