Management complicated hepatolithiasis with operative rigid choledochoscope guided by computed tomography (CT) -based 3D reconstruction technique
Dong, C.-C.; Fang, C.-H.; Wu, T.-C.; Cai, W.; Fan, Y.-F.; Yang, J.; Zeng, N.; Zhong, S.-Z.; Bao, S.-S.
Hepato-Gastroenterology 61(134): 1556-1562
2014
ISSN/ISBN: 0172-6390 PMID: 25436342 Document Number: 674002
Treatment of complicated hepatolithiasis is complex and difficult. In this report, we present a novel approach to manage complicated hepatolithiasis using the rigid choledochoscope guided by CT-based 3D reconstruction technique with or without hepatectomy. Between February 2012 to December 2013, 25 patients with complicated hepatolithiasis underwent rigid choledochoscope guided by CT-based 3D reconstruction technique combined with or without hepatectomy. 27 patients with complicated hepatolithiasis underwent a traditional operation (traditional method group) from June 2011 to January 2012. All operations were performed by the authors. The final stone clearance rate of the rigid choledochoscope group was 96%, whereas that of the traditional method group was 74.1% (P=0.032). There was no patient died of postoperative mortality in two groups. Moreover, the operative time in the traditional method group was significantly longer than that in the rigid choledochoscope group (P=0.010). Recurrent intrahepatic bile duct stones were not found during the follow-up period in the two groups. Operative rigid choledochoscope guided by CT-based 3D reconstruction technique combined with or without hepatectomy may be an effective and safe treatment for complicated hepatolithiasis.