The Complications Observation And Clinical Significance Of One-stage Versus Two-stage Lithotomy With Rigid Choledochoscope For Hepatolithiasis

The morbidity of hepatolithiasis is higher in China.Patients often require multiple surgical treatment.Open surgery have more complications.Most patients have given up the standard treatment for the pain of surgery.The recurrence of hepatolithiasis can cause serious complications such as cholangiocarcinoma.To alleviate the surgical trauma and the patients’ pain becomes the research orientation of scholars today.Stage therapeutics can guarantee the safety of operation,it is the key to totally remove the stone finally.The treatment principle is to relieve the obstruction,control infection and improve liver function,enhance the safety and tolerance of surgery in the later stage;In the second stage,PTCSL was performed,dredge up the biliary Tract;Later stage useing our pioneering application PTCS-IP and secondary piercing remove the stone under tiny bile duct totally and prevent recurrence.Objective:To explore the feasibility and curative effect of the two-stage lithotomy with rigid choledochoscope for hepatolithiasis.Methods:From Jan.2015 to Apr.2018.212 cases of hepatolithiasis patients were enrolled.Divided them into experimental group and control group.PTCSL as the two-stage sugery was performed in the experimental group after PTCD or choledoeholithotomy T-tube drainage.The control group performed PTCSL at first stage.The changes of total bilirubin,direct bilirubin and postoperative complications were compared.Results: there was no statistically significant difference between the two groups genera data(P>0.05).The total bilirubin and direct bilirubin of experimental group were significantly lower than control group(P<0.05).The biliary tract infection were low in the both group(P>0.05).Conclusion: PTCSL perfermed by stage in patients with hepatolithiasis effectively relieve the jaundice symptoms,at the same time reduce the postoperative complications such as biliary infection,improve liver function and patients surgery tolerance,enhance surgical safety and achieve the finally purpose of removing stone totally.