ABSTRACT
The clinical data of 143 patients with type Ⅱ a hepatolithiasis with normal function of the sphincter of Oddi were analyzed.The patients were divided into two groups at random.The data of the 2 groups of patients were compared on the operating time,hospitalization,rates of complication,residual stone rates and recurrence rates.The A group patients underwent laparoscopic video choledochoscopic hepaticocholangiolithotomy,T-tube drainage and choledochoscopic lithotomy.The B group patients underwent laparoscopic video hepatectomy and choledochoscopic lithotomy.For most of the patients in the A group,the treatment had the advantages of less trauma,less complications and quicker recovery.There was no significant differences in residual stone rates and recurrence rates between the two groups.As it was difficult to remove stones in the caudate lobes of Ⅱ a type patients in A group due to the sharp angle between the hepatic duct and bile ducts of the caudate lobe,individualized programs should be adopted according to the location of stones on individual patients.
ABSTRACT
Objective To compare the clinical treatment effects, advantages and disadvantages,and clinical application value of percutaneous liver mirror of gravel (PTCSL) treating hepatolith in two different paths, and provide the reference for the future operations. Methods 81 patients with liver and gallbladder stones form March 2007 to July 2007 were selected, and they were randomly divided into observation group and control group. Observation group take colostomy lithotomy method, which is the one step colostomy lithotomy method, while the control group take two-step methods. Then stone-taking net rate, incidence of complications and hospitalization time were compared between two groups of patients after the treatment cycle of the bleeding. Results After the treatment, statistical results showed that calculi net rate, incidence of complications and length of hospital stay in two groups of patients were not significantly differences (P > 0.05). But the blood loss by the method of one-step colostomy lithotomy in observation group was obviously lower than by the two-step method in control group (P<0.05). Conclusions In clinical, percutaneous liver way mirror lithotripsy (PTCSL) is a more effective method for treatment of hepatolith, two kinds of surgical methods on the path in the clinical treatment effect and complications of the control aspect have the obvious curative effect, but the one-step method of colostomy lithotomy has less blood loss, which under certain conditions can be considered as the choice of operation.