Analysis of the Safety and Effectiveness of Laparoscopy Combined with Choledochoscope in the Treatment of Left Intrahepatic Bile Duct Stones with Choledocholithiasis
Objective:To study the effect of laparoscopy combined with choledochoscope in the treatment of left intrahepatic bile duct stones with choledocholithiasis,and to explore the safety and effectiveness.Method:A total of 180 patients with left intrahepatic bile duct stones with choledocholithiasis in Department of Hepatobiliary and Pancreatic Surgery of Pingxiang People's Hospital from January 2018 to December 2022 were selected for the study and divided into an observation group(90 cases)and a control group(90 cases)according to the random number table method.Patients in the observation group were treated with laparoscopic left hepatectomy combined with choledochoscopy exploration and stone removal,while patients in the control group were treated with conventional open left hepatectomy combined with choledochoscopy exploration.The relevant surgical time,intraoperative blood loss,postoperative stone residue rate,and incidence of complications between two groups of patients were compared.The postoperative time to the ground,gastrointestinal function recovery time,postoperative hospital stay and liver function changes between the two groups of patients were compared.Result:Surgery time in the observation group was longer than that in the control group,and the intraoperative blood loss was less than that of the control group,the postoperative time to the ground,recovery time of gastrointestinal function and hospitalization time were significantly shorter than those of the control group(P<0.05).The postoperative levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)in the observation group were significantly lower than those in the control group(P<0.05).The incidence of perioperative incision infection,bile leakage,biliary bleeding and pulmonary infection in the observation group was 6.67%(6/90),significantly lower than 16.67%(15/90)in the control group(P<0.05).Postoperative follow-up showed that the residual rate of stones in the observation group was 3.33%(3/90),while in the control group it was 2.22%(2/90).There was no statistically significant difference in the residual rate of stones between the two groups(P>0.05).Conclusion:Laparoscopic hepatectomy combined with choledochoscope exploration and lithotomy in the treatment of left intrahepatic bile duct stones with choledocholithiasis can reduce the surgical trauma,promote the rehabilitation of patients,improve the liver function of patients,reduce the occurrence of postoperative complications,and the lithotomy effect and safety are reliable.
LaparoscopyCholedochoscopeIntrahepatic bile duct stonesCholedocholithiasis
万方数据
维普
