RESUMO
BACKGROUND: Treatment of complicated hepatolithiasis is complex and difficult. In this report, we present a novel approach to manage complicated hepatolithiasis using the rigid choledochoscope guided by CT-based 3D reconstruction technique with or without hepatectomy. METHODS: Between February 2012 to December 2013, 25 patients with complicated hepatolithiasis underwent rigid choledochoscope guided by CT-based 3D reconstruction technique combined with or without hepatectomy. 27 patients with complicated hepatolithiasis underwent a traditional operation (traditional method group) from June 2011 to January 2012. All operations were performed by the authors. RESULTS: The final stone clearance rate of the rigid choledochoscope group was 96%, whereas that of the traditional method group was 74.1% (P=0.032). There was no patient died of postoperative mortality in two groups. Moreover, the operative time in the traditional method group was significantly longer than that in the rigid choledochoscope group (P=0.010). Recurrent intrahepatic bile duct stones were not found during the follow-up period in the two groups. CONCLUSIONS: Operative rigid choledochoscope guided by CT-based 3D reconstruction technique combined with or without hepatectomy may be an effective and safe treatment for complicated hepatolithiasis.
Assuntos
Colelitíase/cirurgia , Endoscópios , Endoscopia , Imageamento Tridimensional , Hepatopatias/cirurgia , Interpretação de Imagem Radiográfica Assistida por Computador , Radiografia Intervencionista/métodos , Cirurgia Assistida por Computador , Tomografia Computadorizada por Raios X , Adulto , Idoso , Colelitíase/complicações , Colelitíase/diagnóstico por imagem , Endoscopia/instrumentação , Endoscopia/métodos , Desenho de Equipamento , Feminino , Hepatectomia , Humanos , Hepatopatias/complicações , Hepatopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Valor Preditivo dos Testes , Estudos Retrospectivos , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Bile duct injury (BDI) is one of the serious complications in laparoscopic cholecystectomy (LC), but there is currently a lack of systematic review of risk factors related to BDI after LC. This study conducts meta-analysis on the risk factors related to bile duct injury after LC, the purpose is to provide reference basis for preventing and reducing BDI after LC. METHODS: Using the Computer to retrieve of Chinese and English databases such as CNKI, WANFANG Data, the VIP Network, PubMed, Embase, the Cochrane Library, etc. The time is from the establishment of each database until August 2021. A case-control study is selected that is related to the risk factors of BDI after LC. This meta-analysis using RevMan 5.4 and State 12.0 software is performed after two researchers independently sift through the literature, extract the data, and evaluate the bias risk included in the study. RESULTS: The risk factors related to BDI after LC will be analyzed by systematic review. CONCLUSION: The conclusion of this study will play an important role in reducing BDI after LC. OSF REGISTRATION: DOI 10.17605/OSF.IO/2B3K9, the registration URL is https://osf.io/2b3k9.