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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 |
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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.
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[1] 中华医学会外科学分会胆道外科学组,中国医师协会外科医师分会胆道外科医师委员会.胆道镜在肝胆管结石病诊断与治疗中的应用专家共识(2019版)[J].中华消化外科杂志,2019,18(7):611~615. [2] Lv S,Fang Z,Wang A,et al.Choledochoscopic Holmium Laser Lithotripsy for difficult bile duct stones[J].Laparoendosc Adv Surg Tech A,2017,27(1):24~27. [3] 陈永军,蔡小勇,卢榜裕,等.多镜联合治疗复发性胆石症的体会[J].重庆医学,2018,47(2):244~246. [4] Maggi U,Paone G,Lauro R,et al.Holmium Intraductal Laser Lithotripsy of Biliary Stones in Liver Grafts[J].Transplant Proc,2016,48(2):380~382. [5] 中国研究型医院学会肝胆胰外科专业委员会,国家卫生健康委员会公益性行业科研专项专家委员会.肝胆管结石病微创手术治疗指南(2019版)[J].中华消化外科杂志,2019,18(5):407~413. [6] Phillips E,Berci G,Barber K.The Role of the Video-Choledochoscope[J].Surg Innov,2016,23(5):546~549. [7] Kim SJ,Kim KH,An CH,et al.Innovative technique of needlescopic grasper-assisted single-incision laparoscopic common bile duct exploration:A comparative study[J].World Gastroenterol,2015,21(45):12857~12864. [8] 杨钟良,黄毅.输尿管镜下钬激光碎石与气压弹道碎石术治疗输尿管结石的疗效比较[J].解放军预防医学杂志,2019,37(5):71~72. |
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