ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ SỎI ĐƯỜNG MẬT TRONG GAN BẰNG PHẪU THUẬT NỘI SOI VÀ SỬ DỤNG ỐNG SOI MỀM TÁN THỦY LỰC QUA ỐNG NỐI MẬT DA TẠI BỆNH VIỆN TRUNG ƯƠNG QUÂN ĐỘI 108

Abstract

Objective: To evaluate the results of laparoscopic common bile duct (CBD) exploration to remove hepatolithiasis using cholangioscopy and electrohydraulic lithotripsy (EHL) through the transcholedochal tube tract. Method: Case series study. Result: 60 patients with hepatolithiasis (intrahepatic stones) with or without choledocholithiasis underwent laparoscopic CBD exploration to remove stones using cholangioscopy and electrohydraulic lithotripsy (EHL) through the transcholedochal tube tract during surgery. There was 20 cases with a history of laparotomy. The average age was 54,08 ± 14,45; sex ratio (females/males) was  2,16. The amount of patients coming from rural area accounted for 56,67%. Right upper quadrant pain was witnessed in 59 cases (98,33%) while 36 patients (60%) and 12 patients (20%) getting fever and jaundice respectively. Leukocytosis was common, that occurred in 28,33% of whole cases while high bilirubin levels and elevated aminotransferase levels were seen at 41,67% and 55% respectively. The success rate of postoperative stones clearance was 40% due to ultrasound and cholangiogram images. The major factors that associate with postoperative stones clearance included: biliary stricture and the location of intrahepatic stones. There were no intraoperative complications occurred; 3 cases (5%) of postoperative complication. The average operative time was 129 ± 32,59 minutes; Average postoperative hospital stay was 9,32 ± 3,72 days. Conclusion: Laparoscopic CBD exploration to remove hepatolithiasis using cholangioscopy and EHL through the transcholedochal tube tract yields the safety and effectiveness.