Treatment Of Complicated-hepatolithiasis By Shock-wave Lithotripsy In Vivo (116 Cases Reported)

Objective: To study the clinical significance of Complicated- hepatolithiasis by Shock-wave Lithotripsy in vivo,and popularize the therapeutic experience for it.Methods: A total of 116 patients with Complicated-hepatolithiasis undergone by Shockwave lithotripsy in vivo through choledochscopy from June 2005 to June 2008 were included in the study and divided into 2 groups,103 among them were treated with laparotomy united Shock-wave Lithotripsy in vivo through choledochoscopy,the other 13 with retained calculus of intrahepatic duct were treated with shockwave lithotripsy in vivo through T-tube.A retrospective analysis was carried out by comparing the former(103 cases)with another 110 patients with hepatolithiasis undergone by laparotomy only from Jan 2002 to Dec 2004.The aim is to summarize and popularize the therapeutic experience of Shock-wave Lithotripsy in vivo.Results:8 cases in 103 that treated with laparotomy united shock-wave lithotripsy in vivo had residual stones,with the incidence of residual stones 7.77%(8/103),while the control group was 17.27%,(19/110).Chi square test of these two residual rates showed that their difference had statistic significance(P<0.05). 12 patients in 13 treated with shockwave lithotripsy in vivo through T-tube were entirely removed the stones on one session,with the rate of 92.3%(12/13). Conclusion: Shockwave lithotripsy in vivo through choledochscopy, as a new technology for treating hepatolithiasis, can remarkably reduce the incidence of residual calculus after operation, and avoid unnecessary hepatectomy and digestive tract reconstruction.Its outstanding feature, like high cure rate, fewer complications, remarkable healing effect, makes it a new breakthrough for treatment of hepatolithiasis by endoscope and worth popularizing in clinic application...