ABSTRACT
Objective To learn therapeutic effect of the combined treatment of multiple segmental resection and choledochoscope lithotomy on complex intrahepatic biliary calculi.To provide effective and reliable operation method for the treatment of disease.Methods 213 cases with complex intrahepatic biliary were randomly divided into observation group(117 cases)and control group(96 cases)by random number table method.The control group was treated with multiple segmental resection,the observation group was treated with multiple segmental resection com-bined choledochoscope lithotomy.The postoperative complications of the two groups were observed,and the patients of the two groups were followed up,and the effect of surgical treatment was evaluated.Results The hospitalization time of the observation group was (10.1 ±3.4)d,which was significantly shorter than (13.7 ±4.6)d of the control group (t =6.560,P <0.05).Postoperative 3 -6 weeks residual stone rate of the observation group was 7.69%(9 /117), which was lower than that of the control group,the difference was statistically significant (χ2 =4.099,P <0.05).In both two groups,the average duration of follow -up was (11.2 ±3.9)months.In the observation group,the excellent and good rate of surgery 89.74%(105 /117)was higher than the control group (χ2 =9.154,P <0.05).The postop-erative complication rate of the observation group 18.80%(22 /117)was lower than that of the control group,the difference was statistically significant (χ2 =14.467,P <0.05).Conclusion In the treatment of complex intrahepat-ic biliary calculi,the combined treatment of multiple segmental resection and choledochoscope lithotomy has better curative effect and low postoperative complication rate,with good clinical application value.
ABSTRACT
Objective To investigate the clinical efficacy of liver resection combined intraoperative choledochoscope for intra‐hepatic biliary calculi .Methods A retrospective analysis of clinical data in seventeen patients with intrahepatic biliary calculi ,who have been received liver resection combined intraoperative choledochoscope in the department of hepatobiliary surgery during 2005 to 2014 was conducted .According to the distribution of intrahepatic bile duct stones ,six cases located in left liver lobe ,five cases lo‐cated in left half liver ,three cases located in liver section Ⅵ ,one case located in liver section Ⅶ ,one case located in liver section Ⅷ , one case located in left liver lobe associated with right posterior lobe lower segment .Seventeen cases were treated with hepatolobec‐tomy or segmental liver resection (single clamp method combined first hilar occlusion) ,among which six cases received hepatic left lateral lobectomy ,five cases received left hemihepatectomy ,three cases received partial hepatic resection in paragraph Ⅶ ,one case received partial hepatic resection in paragraph Ⅶ and one in Ⅷ ,one case received the left lateral lobe combined right posterior lower segmental resection ,ten cases at the same time received choledocholithotomy and T tube drainage .Results All patients were cured without serious complications ,no long term stone recurrence .Conclusion Liver resection combined intraoperative choledochoscope is positive and effective treatment for intrahepatic biliary calculi patients .