关键词: 肝胆管结石, 三维可视化系统, 纤维胆道镜, 结石清除, 并发症, 治疗

Abstract: Objective The aim of this study was to investigate the short-term efficacy of three-dimensional visualization system and fiber choledochoscope in guiding hepatectomy in the treatment of patients with hepatolithiasis. Methods 117 patients with hepatolithiasis were encountered in our hospital between September 2015 and September 2020, and 61 patients in observation group received hepatectomy after mimics under the guidance of three-dimensional visualization system, and 56 patients in control received hepatectomy routinely. The changes in peripheral blood T lymphocyte subsets was detected by flow cytometry. Results The surgical time, intraoperative blood loss, postoperative drainage volume, first feeding and postoperative hospital stay in the observation were (159.8±37.4) min, (172.7±56.4) mL, (141.1±34.8) mL, (2.1±0.6) d and (8.1±2.3) d, significantly shorter or less than [(201.5±52.7) min, (241.6±79.5) mL, (195.2±87.4) mL, (2.7±0.8) d and (10.5±2.9) d, respectivelyy, P<0.05)] in the control; the stone clearance rate was significantly higher than that in the control group (95.7% vs. 85.7%, P<0.05); the incidence of postoperative complications was significantly lower than that in the control (6.6% vs. 19.6%, P<0.05) ; the percentage of peripheral blood CD4+ cells and the ratio of CD4+/CD8+ cells were (38.8±5.3)% and (1.9±0.4), which were significantly higher than those in the control group [(34.2±5.5)% and (1.5±0.3), respectively, P<0.05]. Conclusion The hepatectomy under the guidance of three-dimensional visualization system for the treatment of patients with hepatolithiasis could relieve surgical trauma, promote early recovery, elevate stone removal with less incidence of postoperative complications, which warrants further clinical investigation.

Key words: Hepatolithiasis, Three-dimensional visualization system, Fiber choledochoscope, Stone clearance, Postoperative complications, Therapy