Effects of T-tube Sinoscope Combined with Holmium Laser in the treatment of Intrahepatic and Extrahepatic Bile Duct Residual Stones and the Level of Bilirubin Total Bile Acid and Alkaline Phosphatase in Patients
WANG Zhigang, DENG Jianjun, YUE Qijun, et al
Hubei General Hospital of the ArmedPolice, Hubei Wuhan 430061, China
Abstract:Objective: To observe the efficacy of T-tube sinus choledochoscopy combined with holmium laser in the treatment of residual stones of intrahepatic and extrahepatic bile ducts and its effects on levels of related serum biochemical markers. Methods: The clinical data of 50 patients with residual stones of intrahepatic and extrahepatic bile ducts in our hospital from April 2014 to April 2019 were retrospectively analyzed. According to the treatment procedures,they were divided into T-tube sinus choledochoscopy combined with holmium laser group (combined group,n=23) and conventional lithotomy under choledochoscopy group (conventional group, n=27). The operation was observed, and the levels of serum bile biochemical markers [total bilirubin (TBil), total bile acid (TBA), combined bilirubin (DBil)] and hepatic enzyme indicators [alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST)] were compared between the two groups before operation and at 3d after operation. The occurrence of complications was recorded. Results: The operative time and hospital stay in combined group were shorter than those in conventional group, and the success rate of stone removal was higher than that in conventional group (P<0.05). At 3d after operation, the levels of serum TBil, TBA, DBil, ALP, ALT and AST in the two groups were lower than those before operation, and the levels in combined group were lower than those in conventional group (P<0.05). The incidence rate of postoperative complications in combined group was lower than that in conventional group (P<0.05). Conclusion: Compared with conventional stone removal under choledochoscopy, T-tube sinus choledochoscopy combined with holmium laser for residual stones of intrahepatic and extrahepatic bile ducts can significantly improve the operation, enhance the success rate of stone removal, and help regulate bile components, improve liver function and reduce the incidence rate of complications, and it is more advantageous.
王志刚, 邓建军, 岳奇俊, 张政, 刘晓. T型管窦道胆道镜联合钬激光治疗肝内外胆管残余结石的疗效及对患者胆红素总胆汁酸和碱性磷酸酶水平的影响[J]. 河北医学, 2020, 26(5): 771-775.
WANG Zhigang, DENG Jianjun, YUE Qijun, et al. Effects of T-tube Sinoscope Combined with Holmium Laser in the treatment of Intrahepatic and Extrahepatic Bile Duct Residual Stones and the Level of Bilirubin Total Bile Acid and Alkaline Phosphatase in Patients. HeBei Med, 2020, 26(5): 771-775.