Clinical Observation Of 54 Cases Of Residual Intrahepatic Bile Duct Stones Treated With Choledochoscopy Combined With Electro-hydraulic Lithotripsy

Objective : To investigate the efficacy of choledocholithiasis in the treatment of residual stones after intrahepatic bile duct stones,and to provide an effective method for the treatment of residual intrahepatic bile duct stones.Method:A retrospective analysis of 54 patients with residual intrahepatic bile duct stones collected from our hospital from May 2015 to June 2017 was performed with choledochoscopy.Observing the rate of stone removal in 54 cases,the biliary mucosal bleeding in the operation of choledocholithiasis,and the complications such as transient fever and bile leakage after choledochoscopy,and adverse events.Results:In this group of 54 patients with residual stones after intrahepatic bile duct stones,using choledochoscopy combined with electro-hydraulic lithotripsy,the stone removal rate was 87%(47/54).This choledochoscope has a total of 74 stone lithotripsy.One of the choledocholithiasis lithotripsy stones was taken at a rate of 84.2%(32/38).The rate of removal of liquid-electric lithotripsyby choledochoscopy was 92.3%(11/12).Three times using choledochoscopy,liquid-electric lithotripsy stone removal rate of 100%(4/4).In 54 cases of choledocholithiasis,according to intrahepatic bile duct stone classification,the stone removal rate of type I intrahepatic bile duct residual stones was 90.6%,and the stones in the type II intrahepatic bile duct residual stones were taken.The rate was 81.8%.There was no statistically significant difference in the rate of stone removal between the two types of intrahepatic bile duct residual stones(90.6% vs 81.8%,P=0.593)(P>0.05).The incidence of biliary mucosal hemorrhage in choledochoscopy combined with electro-hydraulic lithotripsy was 14.8%(8/54),and the incidence of postoperative transient fever was 16.7%(9/54).There were no complications such as biliary bleeding,bile leakage,water poisoning,peritonitis,and septic shock in 54 cases.There are no adverse events such as stone baskets,liquid-electric stone guide wires broken in the biliary tract in 54 cases.In this group of 54 patients,no stone baskets,liquid-electric stone guidewires were broken and left in the biliary tract and other adverse events occurred.Conclusions:For the treatment of residual stones in the intrahepatic bile duct,choledochoscopy combined with electro-hydraulic lithotripsy is an effective method for stone removal.In the treatment of residual stones after intrahepatic bile duct stones,choledochoscopy combined with hydroelectric lithotripsy did not have serious complications and no adverse events.It is a safe method for removing stones from intrahepatic bile duct stones.