CT三维重建引导下输尿管镜联合钬激光碎石对肝内胆管结石的清除及肝功能分析

目的 探讨CT三维重建引导下输尿管镜联合钬激光碎石治疗肝内胆管结石的效果.方法 选取2019年7月至2020年10月长沙市第三医院接受手术治疗的130例复杂性肝内胆管结石患者作为研究对象进行回顾性分析,其中60例患者采用CT三维重建引导下输尿管镜联合钬激光碎石治疗(研究组)、70例患者采用规则性肝段或肝叶切除术治疗(对...

Clearance of intrahepatic bile ducts and liver function analysis of ureteroscope combined with holmium laser lithotripsy under the guidance of three-dimensional CT reconstruction

Objective To explore the effect of ureteroscope combined with holmium laser lithotripsy under the guidance of CT three-dimensional reconstruction in the treatment of intrahepatic bile duct stones.Methods A retrospective analysis of 130 patients with complicated intrahepatic bile duct stones who underwent surgical treatment in the Third Hospital of Changsha City from July 2019 to October 2020 was selected for retrospective analysis.Among them,60 patients underwent CT three-dimensional reconstruction guided ureteroscopy combined with holmium laser lithotripsy Treatment(study group),70 patients were treated with regular hepatic segment or lobectomy(control group),and the operation time,surgical blood loss,abdominal drainage,postoperative anal exhaust time,and stone removal were compared between the two groups rate,length of hospital stay,serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),peripheral white blood cells(WBC),fasting blood glucose(FBG)before and after surgery,C-reactive protein(CRP)level changes,and compare the surgical complications of the two groups of patients.Results The operation time of the study group was longer than that of the control group,the operation blood loss,abdominal drainage,postoperative anal exhaust time,and hospital stay in the study group were lower than those in the control group,the differences were statistically(P<0.05).There was no statistically significant difference in the stone clearance rate(P>0.05).Before operation,there was no significant difference in the levels of serum ALT,AST and TBIL between the two groups(P>0.05);24 h,72 h after operation,the levels of serum ALT,AST,and TBIL in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before operation,the WBC,CRP,and FBG levels of the two groups were not statistically significant different(P>0.05);at 24 and 72 h after surgery,the serum CRP levels of patients in the study group were lower than those in the control group,and the differences were statistically significant significance(P<0.05),but there was no statistically significant difference in the levels of WBC and FBG between the two groups(P>0.05).The operative complication rate of the study group was 6.67%compared with 14.29%of the control group,the difference was no statistical significance(P>0.05).Conclusion CT three-dimensional reconstruction guided ureteroscopy combined with holmium laser lithotripsy is not much different from regular liver segment or lobectomy in the treatment of intrahepatic bile duct stones,but the former has less surgical trauma,faster postoperative recovery,and greater impact on liver function.small.