关键词: 肝内胆管结石, 硬性胆道镜, 气压弹道碎石取石术, 腹腔镜, 治疗

Abstract: Objective To investigate the clinical efficacy and safety of laparoscopic hard choledochoscopy and pneumatic ballistic lithotripsy in the treatment of patients with intrahepatic bile duct stones. Methods 69 patients with hepatolithiasis were randomly divided into the control group （n=34） and the observation group （n= 35） according to the operation they received. The patients in the control group received traditional surgery,and in the observation group received laparoscopic hard choledochoscope and pneumatic ballistic lithotripsy. Serum IgG,IgM and Ig A levels were detected. Results The operation time,blood loss,T tube removal time and gastrointestinal function recovery time in the observation group were（117.37±10.02） min,（115.32±10.08） mL, （18.55±3.86） h and（2.11±0.65） h,respectively,significantly different as compared to those in the control group [（159.39±12.17） min,（254.02±22.38） mL,（37.32±5.45） h and （3.73±1.07） h,respectively,P<0.05];the ambulation,flatus, hospital stay and residual stone occurrence were（4.90±0.71） d,（33.08±5.45） h,（16.53±3.07） d and 8.57% in the observation group, significantly different compared to those in the control group[（6.59±1.22） d,（58.02±10.11） h,（21.02±4.04） d and 50.00%,respectively,P<0.05];serum levels of IgG,IgM and IgA in the observation group after operation were significantly higher than in the control group（P<0.05）;the postoperative complication rate in the observation group was 11.43%,significantly lower than 35.29% in the control group（P<0.05）. Conclusion Compared with traditional surgery,laparoscopic hard choledochoscopy and pneumatic ballistic lithotripsy in the treatment of patients with hepatolithiasis has a good efficacy with low complications.

Key words: Hepatolithiasis, Laparoscopic hard choledochoscopy, Pneumatic ballistic lithotripsy, Therapy