3D和超声引导经皮肝Ⅰ期造瘘联合硬镜治疗复杂肝胆管结石的临床价值

doi:10.13418/j.issn.1001-165x.2020.03.015

Abstract

Abstract: Objective　To explore the value of three-dimensional (3D) visualization technique combined with ultrasound (US) guided percutaneous transhepatic one-step biliary fistulation lithotripsy for the treatment of complex hepatolithiasis.　Methods　Sixty-five patients with complex hepatolithiasis were collected, which were divided into 2 groups randomly: an observation group and a control group. 33 cases were the observation group (3D+US group), which were treated by 3D technique combined with US-guided percutaneous transhepatic one-step biliary fistulation lithotripsy with rigid choledochoscope; and the other 32 cases were the control group (US group) which were treated by US. The surgery time, surgical bleeding loss, stone clearance rate, postoperative hospitalization time, postoperative complications of the two groups were compared and analyzed.　Results　The surgery time of the 3D+US group （65.6±12.9 min vs 74.5±13.6 min, t=2.686, P=0.009）were shorter than that of the US group, which the differences were statistically significant (P<0.05); but compared with two groups of surgical bleeding loss（22.2±5.4 ml vs 25.7±10.2 ml，t =-1.748，P=0.085）, clearance of stones （93.9% vs 90.6%，χ2=0.251，P=0.616）, postoperative hospitalization time（6.8±2.1d vs 7.2±2.4d，t=0.751，P=0.456） and postoperative complications（9.1% vs 12.5%， χ2=0.196 ，P=0.658）, there were no statistical difference (P>0.05). 　Conclusions　3D visualization combined with US-guided percutaneous transhepatic one-step biliary fistulation is a safe, minimally invasive and highly efficient method for the treatment of complex hepatolithiasis, which may have its potential application in clinical prospects.

Key words: Complex hepatolithiasis;　Percutaneous transhepatic one-step biliary fistulation;　Rigid choledochoscopy;　Three-dimensional visualization technique, 　3D

CLC Number:

FANG Zhao-shan, HUANG Hai, YANG Jian. Application of three-dimensional visualization combined with ultrasound-guided percutaneous transhepatic one-step biliary fistulation lithotripsy with rigid choledochoscope for treating complex hepatolithiasis[J]. Chinese Journal of Clinical Anatomy, 2020, 38(3): 321-326.

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Application of three-dimensional visualization combined with ultrasound-guided percutaneous transhepatic one-step biliary fistulation lithotripsy with rigid choledochoscope for treating complex hepatolithiasis

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