The Study On Treatment Of Hepatolithiasis With Mini-invasive Technique Combined With Holmium Laser

Objective:We Compare the effect of treatments of hepatolithiasis with traditional surgery (group A) and mini-invasive techniques combined with Holmium laser (group B), explore to treatments of hepatolithiasis with mini-invasive techniques combined with holmium laser.Methods:40cases of hepatolithiasis collected from January2008to June2011in the Longgang Central Hospital, Department of General Surgery, divided into traditional surgery (group A) and mini-invasive techniques combined with Holmium laser (group B), Group A20cases, mainly to choledocholithotomy and T-tube drainage; if a large number of stones in the left hepatic outer leaves and accompanied by atrophy fibrosis, left hepatectomy; Severe stenosis of bile duct was implemented biliary-enteric anastomosis, In some cases, The middle of operation or after operation, Fiber choledochoscope exploration remove the stones. In this group Including in choledocholithotomy and T-tube drainage18cases (85%), the left lobe resection3cases (15%),cholecystectomy13cases (65%), biliary-enteric anastomosis2cases (10%); Group B20cases,using Laparoscopy, Choledochofiberscope combined with holmium laser lithotripsy. conventional laparoscopic cholecystectomy, In this group Including in stitched the common bile duct, exempt from the T-tube drainage in3cases (15%); indwelling T-tube drainage in17cases (85%), concurrent acute obstructive cholangitis (AOSC) or biliary pancreatitis4cases (20%), the first ENBD, until a stable condition after surgery. Statistics A,B groups age, T-Bil, ALT, ALB, Child-Pugh score,to analyze whether any significant difference. Intraoperative and postoperative statistics A, B groups the operative time, intraoperative blood loss, postoperative ambulation time,postoperative anal exhaust time, the residual stone rate, postoperative complications, days of hospitalization, to analyze whether any significant difference.Results:Group A and Group B operations were successfully completed, no deaths, no cases of laparotomy. age, T-bil, ALT, ALB, Child-Pugh score in two group were no significant difference(P>0.05). the operative time, intraoperative blood loss, postoperative ambulation time,postoperative anal exhaust time, the residual stone rate, postoperative complications, days of hospitalization in group B were less than in group A (P<0.05)Conclusion:The group B is superior to group A, The treatment of hepatolithiasis with mini-invasive techniques combined with holmium laser is worth to spread because of lower trauma and remnant stones.