Clinical experience in choledochoscopy for the treatment of intrahepatic bile duct stones complicated by biliary stricture: a clinical analysis of 230 cases / 临床肝胆病杂志

ABSTRACT

Objective To investigate the value of choledochoscopy in the treatment of intrahepatic bile duct stones complicated by biliary stricture,treatment methods,and related complications.Methods A retrospective analysis was performed for the clinical data of 230 patients with intrahepatic bile duct stones complicated by biliary stricture who underwent choledochoscopy in Jiangning Hospital Affiliated to Nanjing Medical University from June 2015 to May 2017.The treatment timing and duration of choledochoscopy,number of times of stone removal,and intraoperative complications were observed,and the patients were followed up for 1-3 months to observe residual stones,T tube detachment,and postoperative gastrointestinal reactions.Results Of all patients,229 had benign biliary stricture and 1 had malignant biliary stricture found by choledochoscopy.A total of 692 person-times of choledochoscopy were performed,and the patients underwent 2-7 times of choledochoscopy (mean 3.9 ± 1.1).Each time of choledochoscopy lasted for 25-60 minutes (mean 40.9 ± 11.5 minutes).Choledochoscopy was performed during 90-120 days after surgery (mean 105.0-± 9.5 days).Eight patients experienced T tube detachment,and six of them underwent successful T tube replacement.Of all patients,4 had residual stones after choledochoscopy,resulting in a residual stone rate of 1.73％.There were 83 person-times of postoperative complications including pyrexia,nausea,and diarrhea,which were relieved after symptomatic treatment.Conclusion Choledochoscopy is an important supplemental therapy for the surgical treatment of intrahepatic bile duct stones complicated by biliary stricture and has the features of high efficiency,small trauma,and rapid recovery.Therefore,it holds promise for clinical application.