三维可视化技术引导肝切除联合胆道镜取石术治疗肝内胆管结石

Three-dimensional visualization technology guided hepatectomy combined with cholangioscopic lithotripsy in the treatment of hepatolithiasis

目的 研究三维可视化技术(three-dimensional visualization technology,3DVT)在肝切除联合胆道镜探查取石术治疗肝内胆管结石的应用效果。方法 回顾性分析2018年1月至2020年12月南华大学附属第一医院肝胆胰外科收治的132例肝内胆管结石患者的临床资料,根据术前是否采用3DVT指导分为试验组(n=74)和对照组(n=58),比较两组结石清除的疗效。结果 与对照组比,试验组具有较短的术后住院时间[(15.1±6.9)d vs (19.6±10.9)d,P=0.01]、较高的结石清除率(94.59% vs 82.76%,P=0.028)及较低的结石复发率(6.76% vs 18.97%,P=0.033)。结论 3DVT引导肝切除联合胆道镜探查取石术治疗肝内胆管结石是可行的,对有效清除肝内结石具有较大的优势。

objective To explore the application effect of three-dimensional visualization technology(3DVT) in the treatment of hepatolithiasis by hepatectomy combined with chlangioscopic lithotripsy. Methods The clinical data of 132 patients with cholangioscopic lithotripsy admitted to the First Affiliated Hospital of University of South China from Jan. 2018 to Dec. 2020 were retrospectively analyzed. They were divided into the experimental group(n=74) and the control group(n=58) according to whether 3DVT guidance was adopted before operation, and calculus removal efficacy between the two groups were compared. Results The experimental group had shorter postoperative hospital stay [(15.1±6.9)d vs(19.6±10.9)d, P=0.01], higher stone clearance rate(94.59% vs 82.76%, P=0.028) and lower recurrence rate(6.76% vs 18.97%, P=0.033) than those in the control group. Conclusion 3DVT-guided hepatectomy combined with cholangioscopic lithotripsy is feasible for the treatment of hepatolithiasis, with great advantages in effectively removing intrahepatic bile duct stones.