ABSTRACT
OBJECTIVE: To explore therapeutic strategies of type Ⅲa hepatolithiasis. METHODS: The clinical data of 86 patients with type Ⅲ a hepatolithiasis admitted from July 2014 to December 2017 in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi University of Chinese Medicine were retrospectively analyzed. Patients without liver resection were included. Variables including residual stones,times of choledochoscopy performing,stone clearance rate and recurrence rate were observed. RESULTS: There was a total of 23 patients with biliary strictures and 2 cases of bile leakage after operation,83 patients(96.5%) residual stones after Initial treatment. About six weeks after surgery,the choledochoscopy was performed via T tube sinus or subcutaneous blind loop. The median lithotomy times was 3. There were 4 cases of residual small stones,and stone clearance rate was 95.4%. Median follow-up time was 24 months. 6 patients(7.0%) had recurrent intrahepatic bile duct stones,and the proficiency was 93.0%(80/86). 6 patients(7.0%) had sporadic cholangitis. CONCLUSION: It is safe and feasible to correct the stricture and remove the stones through the combination of biliary surgery and choledochoscope for type Ⅲa hepatolithiasis. The short-term outcomes are satisfactory.