关键词: 肝脏部分切除手术, 胆道镜, 结合治疗, 肝内胆管结石, 临床效果, 并发症

Abstract:

Objective To investigate the clinical effect of partial hepatectomy combined with choledochoscopy in the treatment of intrahepatic bile duct stones. Method 84 patients with intrahepatic bile duct stones who underwent partial hepatectomy in Hepatobiliary Hospital of Jilin from July 2020 to June 2021 were randomly divided into resection group and combination group. Partial hepatectomy was performed in the resection group, and partial hepatectomy combined with choledochoscopy was performed in the combined group. The changes of operation related indexes in the two groups were compared, and the postoperative complications and liver function were monitored. Result The intraoperative blood loss in the combined group was less than that in the resection group. The recovery time of postoperative bowel sounds, postoperative defecation time, postoperative out of bed activity time and hospital stay in the resection group were significantly shorter than those in the resection group (P ＜ 0.05); the incidence of complications in the combination group (9.52%) was significantly lower than that in the resection group (26.19%) (P ＜ 0.05). The recurrence rate of the combined group was significantly lower than that of the resection group (11.90%) (P ＜ 0.05). The levels of alanine aminotransferase, aspartate aminotransferase, total bile acid and total bilirubin in the combination group were significantly lower than those in the resection group (P ＜ 0.05). Conclusion Partial hepatectomy combined with choledochoscopy can reduce intraoperative blood loss, promote patients' recovery as soon as possible, effectively reduce the risk of complications and recurrence rate, and improve the level of postoperative liver function indicators.

Key words: Partial hepatectomy, Choledochoscopy, Combination therapy, Intrahepatic bile duct stones, Clinical effect, Complication