Clinical Efficacy Analysis Of Percutaneous Transhepatic Choledochoscopy In The Treatment Of Complex Intrahepatic And Extrahepatic Bile Duct Stones

Objective: By collecting and analyzing the case data of patients with complex intrahepatic and extrahepatic bile duct stones admitted to the Affiliated Hospital of Qinghai University,this study aimed to evaluate the efficacy of percutaneous transhepatic choledochoscopy(hereinafter collectively referred to as PTCS)in the treatment of complex intrahepatic bile duct stones in our hospital.The implementation situation,as well as its safety,feasibility,technical implementation points,and clinical value in the treatment of patients’ conditions will be further analyzed,so as to provide a reference for the promotion of this surgical technique in this region.Methods: The case data of 60 patients with complicated intrahepatic and extrahepatic bile duct stones admitted to Qinghai University Affiliated Hospital from January 2019 to October 2021 were retrospectively analyzed.(40 cases).The names,gender,age,preoperative liver function,calculus distribution,comorbidities,postoperative hepatic function,surgical stone removal time,intestinal ventilation time,stone removal,postoperative complications,and hospitalization of patients in each group were collected.The data such as cost,hospital stay and other data were analyzed and compared.Results: There were statistically significant differences between the PTCS group and the laparoscopic group in terms of operation time,intraoperative bleeding,postoperative ventilation,postoperative total bilirubin,postoperative ALT,postoperative AST,stone removal effect,and hospitalization costs(P<0.05).),the comparison of liver function(total bilirubin,ALT,AST)between the two groups before and after surgery,as well as the difference in liver function before and after surgery between the two groups were statistically significant(P<0.05).There were no significant differences in the number of lithotripsy operations,length of hospital stay,and postoperative complications(biliary leakage,biliary tract hemorrhage,biliary tract infection,and incision infection)(P>0.05).Conclusion: PTCS stone extraction technique in the treatment of complicated intrahepatic and extrahepatic calculi patients has the advantages of low cost,less bleeding,less trauma,and faster stone removal time,which is in line with the concept of minimally invasive and precision medicine,especially for patients with multiple biliary tract operations and elderly patients with calculi.The technique is more worthy of promotion.