经皮经肝胆道镜取石术在复发性胆总管结石中的应用研究OACSTPCD

Objective:To explore the clinical efficacy of percutaneous transhepatic cholangioscopy(PTCS)for recurrent chole-docholithiasis.Methods:Clinical data of 83 patients with recurrent choledocholithiasis who underwent biliary tract surgery between Jun.2020 and Jun.2023 were included.Among them,40 patients were treated with PTCS(PTCS group),and 43 cases were treated with laparoscopic common bile duct exploration(LCBDE)as the LCBDE group.The surgical outcomes and postoperative recovery were com-pared between the two groups.Results:In PTCS group 39 surgeries were successfully completed,one case was converted to LCBDE with a conversionrateof2.5％(1/40).There were no significant differences in general data,total operation time,intraoperative blood loss,common bile duct diameter,number of calculi,maximum stone diameter,postoperative gastrointestinal quality of life index,postoperative laboratory examination(except neutrophils),T-tube drainage volume(except the third day),and incidence of surgical complications between the two groups(P>0.05).The operation time(except ultrasound positioning),total operation time at the third year,number of postoperative analgesics,postoperative resumption of feeding time,pain score,hospital stay,postoperative hospitalization cost,risk of catheter slippage,postoperative neutrophils,and T-tube drainage volume on the third postoperative day in PTCS group were less than those in LCBDE group(P<0.05).Conclusions:PTCS and LCBDE are both feasible in treatment of recurrent choledocholithiasis.Compared with LCBDE,PTCS has more advantages in minimally invasive aspect.