Effectiveness and safety analyses of electronic choledochoscopy in treatment of intrahepatic bile duct stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANG Guochun , CHEN Honggang , LIU Qifei , LIU Hongyan , ZHAO Qin

Department of Emergency Surgery, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, P.R.China;

Corresponding?author：

YANG Guochun, Email: yangguochun25@yeah.net

Keywords：

electronic choledochoscopy; intrahepatic bile duct stone; effectiveness; safety

DOI：

10.7507/1007-9424.201612020

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate effectiveness and safety of electronic choledochoscopy in treatment of intrahepatic bile duct stones. Methods From July 2013 to February 2016, 280 patients with intrahepatic bile duct stones in the Department of General Surgery of the Affiliated Hospital of Shandong Academy of Medical Sciences were selected as the research objects. All the patients were randomly divided into a choledochoscopy treatment group and a conventional treatment group by envelope principle method. There were 140 patients in each group. The safety and short- and long-term effectiveness were compared in these two groups. This study was approved by the ethics committee of the hospital. Results ① The age, gender, body mass index, course of disease, and location of stone had no significant differences in these two groups (P>0.05). ② The operations and the net stones were successfully completed in all the patients. The operative time was shorter, the blood loss was less, the incision length was smaller, the postoperative anal exhaust time was earlier, and the hospitalization time was shorter in the choledochoscopy treatment group as compared with the conventional treatment group (P<0.05). ③ The total postoperative complication rate on day 14 in the choledochoscopy treatment group was 2.9% (4/140), which was significantly lower than that in the conventional treatment group (11.4%, 16/140, P<0.05). ④ The curative excellent and good rates was 97.9% and 85.0% in the choledochoscopy treatment group and conventional treatment group respectively, which was a significant difference in these two groups (P<0.05). ⑤ The postoperative serum ALT and AST values on month 6 in the choledochoscopy treatment group were significantly lower than those in the conventional treatment group (P<0.05). Conclusion Electronic choledochoscopy in treatment of intrahepatic bile duct stones could promote rehabilitation of patient, reduce incidence of postoperative complications, and it is conducive to promoting recovery of liver function and improving follow-up effect.

Citation： YANG Guochun, CHEN Honggang, LIU Qifei, LIU Hongyan, ZHAO Qin. Effectiveness and safety analyses of electronic choledochoscopy in treatment of intrahepatic bile duct stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(8): 987-991. doi: 10.7507/1007-9424.201612020 Copy

1.	蘇生藹. 肝內膽管結石的外科治療措施綜合療效分析. 中國實用醫刊, 2016, 43(3): 34-35.
2.	陳忠堯, 周錢江, 袁建南, 等. 肝葉、段切除治療肝內膽管結石 52 例分析. 浙江醫學, 2016, 38(12): 1013-1015.
3.	Yokoyama K, Hatanaka H, Inoue M, et al. Multiple orifices and cholangiography with a " fire-like” appearance after Kasai hepatoportoenterostomy for biliary atresia. J Pediatr Surg, 2016, 51(9): 1574-1576.
4.	徐勇士, 劉義武, 凌曉明. 腹腔鏡和膽道鏡治療高齡膽囊合并膽總管結石分析. 中華普外科手術學雜志(電子版), 2016, 4(1): 70-72.
5.	石電威. 腹腔鏡聯合膽道鏡治療膽結石的療效分析. 臨床醫藥文獻電子雜志, 2016, 3(18): 3597-3597, 3599.
6.	李新豐, 王偉, 王高雄, 等. 腹腔鏡聯合膽道鏡體內碎石治療老年人肝外膽道結石. 中華診斷學電子雜志, 2015, 16(3): 221.
7.	Lee CF, Lee WC, Wu RC, et al. Intrahepatic duct stones harboring ascariasis ova: A case report. Medicine (Baltimore), 2016, 95(12): e3139.
8.	Cannavale A, Bezzi M, Cereatti F, et al. Combined radiological-endoscopic management of difficult bile duct stones: 18-year single center experience. Therap Adv Gastroenterol, 2015, 8(6): 340-351.
9.	Clemente G, De Rose AM, Murri R, et al. Liver resection for primary intrahepatic stones: focus on postoperative infectious complications. World J Surg, 2016, 40(2): 433-439.
10.	Xu G, Wen J, Wang B, et al. The clinical efficacy and safety of ureteroscopic laser papillotomy to treat intraductal papillary calculi associated with medullary sponge kidney. Urology, 2015, 86(3): 472-476.
11.	徐恕, 張劍權, 符國珍, 等. 經皮肝穿刺膽管造瘺電子膽道鏡取石術治療肝內膽管結石的近遠期療效. 中華普通外科雜志, 2016, 31(3): 212-214.
12.	Zhang R, Luo H, Pan Y, et al. Rate of duodenal-biliary reflux increases in patients with recurrent common bile duct stones: evidence from barium meal examination. Gastrointest Endosc, 2015, 82(4): 660-665.
13.	陳永標, 池小斌, 江藝, 等. 腹腔鏡肝切除聯合膽道鏡治療肝內外膽管結石 36 例. 中國微創外科雜志, 2016, 16(9): 777-779.
14.	Yang YL, Zhang C, Zhao G, et al. Choledochoscopic high-frequency needle-knife electrotomy as an effective treatment for intrahepatic biliary strictures. J Gastroenterol Hepatol, 2015, 30(9): 1438-1443.
15.	Shin YC, Jang JY, Kang MJ, et al. Comparison of laparoscopic versus open left-sided hepatectomy for intrahepatic duct stones. Surg Endosc, 2016, 30(1): 259-265.
16.	駱偉, 孟文勃, 岳平, 等. 膽腸吻合術后膽管結石復發的內鏡外科治療進展. 中華消化內鏡雜志, 2016, 33(2): 130-133.
17.	Lee JH, Kim HW, Kang DH, et al. Usefulness of percutaneous transhepatic cholangioscopic lithotomy for removal of difficult common bile duct stones. Clin Endosc, 2013, 46(1): 65-70.
18.	Wang P, Sun B, Huang B, et al. Comparison between percutaneous transhepatic rigid cholangioscopic lithotripsy and conventional percutaneous transhepatic cholangioscopic surgery for hepatolithiasis treatment. Surg Laparosc Endosc Percutan Tech, 2016, 26(1): 54-59.
19.	Ma S, Hu S, Gao F, et al. Endoscopy lithotomy for intrahepatic gallstones: a meta-analysis. Surg Laparosc Endosc Percutan Tech, 2015, 25(4): 269-274.
20.	Kim YK, Han HS, Yoon YS, et al. Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment. World J Surg, 2015, 39(5): 1224-1230.
21.	Dong CC, Fang CH, Wu TC, et al. Management complicated hepatolithiasis with operative rigid choledochoscope guided by computed tomography (CT)-based 3D reconstruction technique. Hepatogastroenterology, 2014, 61(134): 1556-1562.
22.	Kassem MI, Sorour MA, Ghazal AH, et al. Management of intrahepatic stones: the role of subcutaneous hepaticojejunal access loop. A prospective cohort study. Int J Surg, 2014, 12(9): 886-892.
23.	楊曉平, 王平, 蔡陽, 等. 肝切除術治療肝內膽管結石伴膽道出血. 浙江臨床醫學, 2016, 18(5): 863-864.

1. 蘇生藹. 肝內膽管結石的外科治療措施綜合療效分析. 中國實用醫刊, 2016, 43(3): 34-35.
2. 陳忠堯, 周錢江, 袁建南, 等. 肝葉、段切除治療肝內膽管結石 52 例分析. 浙江醫學, 2016, 38(12): 1013-1015.
3. Yokoyama K, Hatanaka H, Inoue M, et al. Multiple orifices and cholangiography with a " fire-like” appearance after Kasai hepatoportoenterostomy for biliary atresia. J Pediatr Surg, 2016, 51(9): 1574-1576.
4. 徐勇士, 劉義武, 凌曉明. 腹腔鏡和膽道鏡治療高齡膽囊合并膽總管結石分析. 中華普外科手術學雜志(電子版), 2016, 4(1): 70-72.
5. 石電威. 腹腔鏡聯合膽道鏡治療膽結石的療效分析. 臨床醫藥文獻電子雜志, 2016, 3(18): 3597-3597, 3599.
6. 李新豐, 王偉, 王高雄, 等. 腹腔鏡聯合膽道鏡體內碎石治療老年人肝外膽道結石. 中華診斷學電子雜志, 2015, 16(3): 221.
7. Lee CF, Lee WC, Wu RC, et al. Intrahepatic duct stones harboring ascariasis ova: A case report. Medicine (Baltimore), 2016, 95(12): e3139.
8. Cannavale A, Bezzi M, Cereatti F, et al. Combined radiological-endoscopic management of difficult bile duct stones: 18-year single center experience. Therap Adv Gastroenterol, 2015, 8(6): 340-351.
9. Clemente G, De Rose AM, Murri R, et al. Liver resection for primary intrahepatic stones: focus on postoperative infectious complications. World J Surg, 2016, 40(2): 433-439.
10. Xu G, Wen J, Wang B, et al. The clinical efficacy and safety of ureteroscopic laser papillotomy to treat intraductal papillary calculi associated with medullary sponge kidney. Urology, 2015, 86(3): 472-476.
11. 徐恕, 張劍權, 符國珍, 等. 經皮肝穿刺膽管造瘺電子膽道鏡取石術治療肝內膽管結石的近遠期療效. 中華普通外科雜志, 2016, 31(3): 212-214.
12. Zhang R, Luo H, Pan Y, et al. Rate of duodenal-biliary reflux increases in patients with recurrent common bile duct stones: evidence from barium meal examination. Gastrointest Endosc, 2015, 82(4): 660-665.
13. 陳永標, 池小斌, 江藝, 等. 腹腔鏡肝切除聯合膽道鏡治療肝內外膽管結石 36 例. 中國微創外科雜志, 2016, 16(9): 777-779.
14. Yang YL, Zhang C, Zhao G, et al. Choledochoscopic high-frequency needle-knife electrotomy as an effective treatment for intrahepatic biliary strictures. J Gastroenterol Hepatol, 2015, 30(9): 1438-1443.
15. Shin YC, Jang JY, Kang MJ, et al. Comparison of laparoscopic versus open left-sided hepatectomy for intrahepatic duct stones. Surg Endosc, 2016, 30(1): 259-265.
16. 駱偉, 孟文勃, 岳平, 等. 膽腸吻合術后膽管結石復發的內鏡外科治療進展. 中華消化內鏡雜志, 2016, 33(2): 130-133.
17. Lee JH, Kim HW, Kang DH, et al. Usefulness of percutaneous transhepatic cholangioscopic lithotomy for removal of difficult common bile duct stones. Clin Endosc, 2013, 46(1): 65-70.
18. Wang P, Sun B, Huang B, et al. Comparison between percutaneous transhepatic rigid cholangioscopic lithotripsy and conventional percutaneous transhepatic cholangioscopic surgery for hepatolithiasis treatment. Surg Laparosc Endosc Percutan Tech, 2016, 26(1): 54-59.
19. Ma S, Hu S, Gao F, et al. Endoscopy lithotomy for intrahepatic gallstones: a meta-analysis. Surg Laparosc Endosc Percutan Tech, 2015, 25(4): 269-274.
20. Kim YK, Han HS, Yoon YS, et al. Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment. World J Surg, 2015, 39(5): 1224-1230.
21. Dong CC, Fang CH, Wu TC, et al. Management complicated hepatolithiasis with operative rigid choledochoscope guided by computed tomography (CT)-based 3D reconstruction technique. Hepatogastroenterology, 2014, 61(134): 1556-1562.
22. Kassem MI, Sorour MA, Ghazal AH, et al. Management of intrahepatic stones: the role of subcutaneous hepaticojejunal access loop. A prospective cohort study. Int J Surg, 2014, 12(9): 886-892.
23. 楊曉平, 王平, 蔡陽, 等. 肝切除術治療肝內膽管結石伴膽道出血. 浙江臨床醫學, 2016, 18(5): 863-864.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effectiveness and safety analyses of electronic choledochoscopy in treatment of intrahepatic bile duct stones

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content