Comparative Effect Analysis On Hepatolith Patients By Two Different Path Percutaneous Transhepatic Cholangioscopic Lithotripsy

Objective:To determine the advantages, disadvantages and clinical value of two different pathways of percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) for the treatment of hepatolith patients.Methods:This retrospective study enrolled 100 hepatolith cases treated in our department from January 2013 to November 2014. Those patients were divided into two groups including the control group of 50 cases (using the method of step repeatedly for stone) and the other 50 cases of experiment group (made repeatedly lithotomy by two step method). The key clinical parameters including calculi net rate, complication rate, intraoperative blood loss, hospital stay time, the stone-free rate wer assessed in our present study.Results:The intraoperative blood loss in control group were 55.17±20.31 ml, which was significantly different from the experiment group 37.82±18.12ml. Of the control group, there was 1 case whose intraoperative blood loss as many as 250 ml due to the expansion process of fistula. The calculi exhausted rate of the Control group was 82.00%(41/50), which were not statistical significance compared to the experiment group (94.00%,44/50). The hospitalization time of the control group were 23.47±5.13 days, which was significantly different from the experiment group (7.64 ±5.02, P< 0.05). The net rate and stones recurrence rate of the control group was 82.00% and 21.87%, respectively, while the rate in the experiment group were 94.00% and 6.25%, respectively. There were 16 cases accumulated with complication in the control group including 9 cholangitis,2 biliary tract hemorrhages, and 5 drainage tube fall off. There were 14 cases accumulated with complication in the experiment group including 7 cholangitis,5 biliary tract hemorrhage, and 2 drainage tube fall off. There was no statistically significant difference of the incidence of postoperative complications and mortality between the control and experiment group (P> 0.05).Conclusion:PTCSL technology is an effective method for clinical treatment of hepatolith. The two pathways of PTCSL technology have some advantages including good therapeutic effect, safety, and shorter total treatment time. Besides, two-step method of colostomy lithotomy has less blood loss, and shorter hospitalization time, which makes it be superior to the one-step method.