Clinical Study Of Percutaneous Transhepatic Choledochoscopic Lithotomy In The Treatment Of Complex Hepatolithiasis

Objective:To analyze and explore the clinical effect and application value of percutaneous transhepatic choledochoscopy in the treatment of complex hepatolithiasis.Methods:The clinical treatment process of patients with complex hepatolithiasis treated in the second affiliated Hospital of Fujian Medical University from 1st October,2017 to 30 th June,2019 was analyzed retrospectively.22 cases with completely medical records were selected and followed up for 4 to 15 months.The basic information of the cases,the relevant indexes of the operation,the probability of perioperative complications,the residual rate of postoperative stones and the recurrence rate of postoperative stones were recorded and analyzed.IBM SPSS Statistics 20.0 statistical analysis software was used to describe the recorded data,and only percentile representation was retained for all results.Results:The 22 cases were all operated successfully.There were no cases of death and loss of follow-up during hospitalization and follow-up.There were 11 cases of residual stones,3 cases of stone recurrence,6 cases of perioperative complications,6 cases of recurrent cholangitis and 15 cases of stone treatment.Conclusions:1.Percutaneous transhepatic choledochoscopic lithotripsy is feasible in the treatment of residual and recurrent stones of intrahepatic bile duct stones,and its operation channel is optimized.Hard choledochoscopy combined with pneumatic lithotripsy or holmium laser lithotripsy in the treatment of complex intrahepatic bile duct stones can leave as much liver tissue as possible,with little damage to liver function,and has the advantages of less trauma,simplicity,repeatablity,rapid recovery and low incidence of postoperative complications,which deserves to be popularized.2.The key goal of the treatment of complex hepatolithiasis is to remove the stones completely and to avoid the recurrence of hepatolithiasis.Postoperative stone residual and stone recurrence are still a short-term as well as a long-term problem in the treatment of complex hepatolithiasis.