The study on treatment of hepatolithiasis with mini-invasive technique combined with holmium laser

Keywords:holmium laser, Holmium Fiber,  Time:27-07-2015

Objective: We Compare the effect of treatments of hepatolithiasis with traditional surgery (group A ) and mini-invasive techniques combined with Holmium laser (group B),explore to treatments of hepatolithiasis with mini-invasive techniques combined with holmium laser.

Key Words: hepatolithiasis; mini-invasive techniques; holmium laser; laparoscopy;choledochofiberscope ;

Methods : 40 cases of hepatolithiasis collected from January 2008 to June 2011 in the Longgang Central Hospital, Department of General Surgery, divided into traditional surgery (group A) and mini-invasive techniques combined with Holmium laser (group B),Group A 20 cases, mainly to choledocholithotomy and T-tube drainage; if a large number of stones in the left hepatic outer leaves and accompanied by atrophy fibrosis , left hepatectomy; Severe stenosis of bile duct was implemented biliary-enteric anastomosis, In some cases, The middle of operation or after operation, Fiber choledochoscope exploration、remove the stones. In this group Including in choledocholithotomy and T-tube drainage 18 cases (85%), the left lobe resection 3cases (15%),cholecystectomy 13 cases (65%), biliary-enteric anastomosis 2 cases (10%); Group B 20 cases,using Laparoscopy,Choledochofiberscope combined with holmium laser lithotripsy, conventional laparoscopic cholecystectomy, In this group Including in stitched the common bile duct, exempt from the T-tube drainage in 3 cases (15%); indwelling T-tube drainage in 17 cases (85%),concurrent acute obstructive cholangitis (AOSC) or biliary pancreatitis 4 cases (20%)?the first ENBD,until a stable condition after surgery. Statistics A,B groups age, T-Bil, ALT,ALB,Child-Pugh score,to analyze whether any significant difference. Intraoperative and postoperative statistics A, B groups the operative time, intraoperative blood loss,postoperative ambulation time,postoperative anal exhaust time, the residual stone rate,postoperative complications, days of hospitalization, to analyze whether any significant difference.

Results: Group A and Group B operations were successfully completed, no deaths, no cases of laparotomy, age, T-bil, ALT, ALB,Child-Pugh score in two group were no significant difference(P> 0.05). the operative time, intraoperative blood loss, postoperative ambulation time,postoperative anal exhaust time, the residual stone rate, postoperative complications, days of hospitalization in group B were less than in group A (P<0.05).Conclusion: The group B is superior to group A,The treatment of hepatolithiasis with mini-invasive techniques combined with holmium laser is worth to spread because of lower trauma and remnant stones.
lithotripsy.