Application of holmium laser lithotripsy combined with endoscopic retrograde cholangiopancreatography in refractory common bile duct stones

Abstract

Abstract: Objective To observe the clinical effect of combined holmium laser lithotripsy and endoscopic retrograde cholangiopancreatography in patients with refractory common bile duct stones (CBDS).Methods A total of 85 patients with refractory CBDS who were admitted to the Third Hospital of Shijiazhuang City (June 2019 to May 2021) were selected and divided into study groups (holmium laser lithotripsy + endoscopic retrograde cholangiopancreatography) according to different surgical Methods. treatment, 44 cases) and control group (surgical treatment of choledocholithotomy, 41 cases). The operation-related indicators, stone removal success rate, inflammatory factor levels and complications were compared between the two groups.Results The operation time of the study group [(35.28±10.15) vs (102.57±34.56) min], postoperative bed time [(1.58±0.37) vs (3.86±0.73) d] and hospital stay [(6.41±0.52) vs (11.85) ±2.76)d] were shorter (t=12.361, 18.347, 12.837, all P<0.001). The success rate of stone removal in the study group (97.73% vs 95.12%) was similar (χ²=0.423, P=0.515). The postoperative IL-1β[(6.48±0.81)vs(25.46±4.83)ng/mL], IL-6[(4.73±1.15)vs(13.75±2.86)ng/mL] and TNF-α[(2.56) ±0.46) vs (6.85±0.76) μg/mL] levels were lower (t=25.639, 19.318, 31.729, all P<0.001). The total incidence of complications in the study group (4.55% vs 21.95%) was lower (χ²=5.707, P=0.017).Conclusion The combination of holmium laser lithotripsy and endoscopic retrograde cholangiopancreatography is effective in the treatment of refractory CBDS patients.

Key words: Holmium laser, Lithotripsy, Endoscopic retrograde cholangiopancreatography, Refractory choledocholithiasis

DONG Yao, ZHANG Jing, SHANG Na, WANG Na. Application of holmium laser lithotripsy combined with endoscopic retrograde cholangiopancreatography in refractory common bile duct stones[J]. Chinese Hepatolgy, 2022, 27(11): 1227-1229.

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