The application in the treatment of extra-and intrahepatic cholangiolithiasis by laparoscopy with choledochoscope combined with holmium laser lithotripsy

Objective To investigate the therapeutic effect and application value in the treatment of intra-and extra- hepatolithiasis by laparoscopy with choledochoscope combined with holmium laser lithotripsy. Methods sixty patients who suffered from intra-and extra-hepatolithiasis were divided into two groups. Control group, 30 cases were treated by laparoscopy with choledochoscope. Observation group, 30 cases were treated by laparoscopy with choledochoscope combined with holmium laser lithotripsy. Clinical effects were compared between the two groups. Results Control group: 25 cases had complete removal of all residual stones with the success rate of 83.3%. Mean operating time was 100±25 min, Mean hospital stay was 8.0±3.1days, 2 case was suffered from open operation.4 cases existed residual stones, were treated by choledochoscope through T tubules sinus tract. 3 cases developed postoperative bile leakage and they were cured through conservative treatment. Observation group: 28 cases had complete removal of all residual stones with the success rate of 93.3%. Mean operating time was 135±32 min, Mean hospital stay was 8.2±3.3 days. 1 cases existed residual stones, were treated by choledochoscope through T tubules sinus tract. No cases developed postoperative bile leakage. There was significant difference in the groups of patients in the success rate of removal stones, mean operating time, incidence of postoperative bile leakage (P＜0.05). Conclusions It is safe and effective to treat intra-and extra-hepatolithiasis by laparoscopy with choledochoscope combined with holmium laser lithotripsy