Clinical Value And Analysis Of Choledochoscope For The Treatment Of Intra-or Extra-hepatic Iithiasis Reoperation

Objective To compare the choledochoscope group and routine in the reoperation of bileduct of liver inside and outside of the average operation time, hospitalization time,remove T tube time,clinical symptom improvement rates,postoperative complications,rate of postoperative residual stones situation, in order to discussion the clinical effect ofbiliary calculi treatment in reoperation by fiber choledochoscope auxiliary surgical.Methods Retrospective analysis from January2011to June2012for the first affiliatedhospital of anhui medical university hospital treatment of111cases of biliaryreoperation calculi patients divided into choledochoscope group of56patients (group A)and the conventional surgical55cases (group B). Comparative study of two groups ofoperation process and results of relevant indicators, including the mean surgery time,hospitalization time, remove T tube time,clinical symptom improvementrates,postoperative complications, rate of postoperative residual stones for statisticalanalysis, according to this evaluation the clinical effect of biliary calculi treatment byCholedochoscope.Results Two groups of average operation time respectively for111±18and108±13（tvalue of0.82,p value of0.36); Length of hospital stay respectively for12±5and11±3(t value of0.22, p value of0.64); A group and B group of clinical symptom periodwere100%, The above three groups statistically no obvious difference. Two groups ofT tube removed time is respectively for29±8and41±21（t value of18.05, p value＜0.01); incidence of postoperative complications were1.78%and21.81%(χ2valueof8.92, p value of0.003), surgery after residual stone rate respectively for7.14%and 29.09%(χ2value of7.62, p value of0.006)，the three groups of statistically havesignificant difference.Conclusion1. Choledochofiberscope assisted surgery can reduce the blindness of exploration andextraction of the stones in the reoperation for biliary calculi, significantly improvethe stone clearance rate, avoid iatrogenic injuries and reduce postoperativecomplications.2. It may shorten the postoperative intubation time, reduce the complications related toT-tubes and improve the quality of life.3. Choledochofiberscope assisted surgery is an effective way to treat with reoperationfor intra-and extrahepatic bile duct stone, which can be used to select rational typesof operation and further reduce the bile duct reoperative rate, in order to attain thegoal of systematization, individualization and eventual “radical” treatment plan forbiliary calculi.