U100激光联合气压弹道与经皮经肝胆道镜取石术治疗肝内外胆管结石的疗效比较及其对肝功能的影响

Comparative study of the effect of U100 laser and pneumatic ballistic combined with percutaneous transhepatic cholangioscopic lithotomy in the treatment of intra-and extrahepatic bile duct stones and its effect on liver function.

作者信息

Yin Zhongliang, Shen Bin

机构信息

Zhongliang Yin, Dept. of Surgery, Jiaxing Maternal and Child Health Hospital, Jiaxing, Zhejiang Province 314001, P.R. China.

Bin Shen, Dept. of Surgery, Jiaxing Traditional Chinese Medicine Hospital, Jiaxing, Zhejiang Province 314000, P.R. China.

出版信息

Pak J Med Sci. 2022 Jul-Aug;38(6):1686-1690. doi: 10.12669/pjms.38.6.5903.

DOI:10.12669/pjms.38.6.5903

PMID:35991255

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9378421/

Abstract

OBJECTIVES

To compare the efficiency of U100 laser and pneumatic ballistics combined with percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) in the treatment of intra-and extrahepatic bile duct stones and their effects on liver function.

METHODS

Medical records of 97 patients with intra-and extrahepatic bile duct stones treated in our hospital from May 2020 to May 2021 were selected for retrospective analysis. Of them, forty-three patients received pneumatic ballistic lithotripsy combined with PTCSL (Group-I), and 54 patients received U100 laser lithotripsy combined with PTCSL (Group-II). The therapeutic effects of the treatment in two groups and its effect on liver function were compared and analyzed.

RESULTS

There was no significant difference in the operation time and intraoperative bleeding (P>0.05) between the two groups. The postoperative pain duration and hospital stay of patients treated with U100 laser lithotripsy combined with PTCSL (Group-II) were shorter than those treated with pneumatic ballistic lithotripsy combined with PTCSL (Group-I), P<0.05. The biliary bleeding rate of patients in Group-II was lower (3.70%) than those in Group-I (16.27%, P<0.05), and the stone residue rate of patients in Group-II was also lower (1.85%) than those in Group-I (11.63%, P<0.05). The levels of total bilirubin (TBIL), alanine aminotransferase (ALT) and albumin (ALB) in Group-II patients were higher than in patients in Group-I.(P<0.05).

CONCLUSION

Compared with pneumatic ballistics, U100 laser lithotripsy combined with PTCSL in the treatment of intra and extrahepatic bile duct stones has the advantages of less postoperative pain, shorter hospital stay, less biliary bleeding and stone residue, and less damage to liver function.

摘要

目的

比较U100激光联合气压弹道与经皮经肝胆道镜碎石术（PTCSL）治疗肝内外胆管结石的疗效及其对肝功能的影响。

方法

选取2020年5月至2021年5月在我院接受治疗的97例肝内外胆管结石患者的病历进行回顾性分析。其中，43例患者接受气压弹道碎石联合PTCSL（第一组），54例患者接受U100激光碎石联合PTCSL（第二组）。比较分析两组治疗效果及其对肝功能的影响。

结果

两组手术时间和术中出血量比较，差异无统计学意义（P>0.05）。U100激光碎石联合PTCSL治疗的患者（第二组）术后疼痛持续时间和住院时间短于气压弹道碎石联合PTCSL治疗的患者（第一组），P<0.05。第二组患者胆道出血率低于第一组（3.70%比16.27%，P<0.05），第二组患者结石残留率也低于第一组（1.85%比11.63%，P<0.05）。第二组患者总胆红素（TBIL）、谷丙转氨酶（ALT）和白蛋白（ALB）水平高于第一组患者（P<0.05）。