Abstract: Objective The aim of this study was to investigate percutaneous transhepatic one-stage rigid choledochoscopyfollowed by pneumatic lithotripsy (PL) in the treatment of patients with intrahepatic bile duct stones (IBDS). Methods 69 patients with IBDS were encountered in our hospital between October 2022 and October 2024, and 25 patients in control were assigned to undergo open surgery, and 44 patients in observation were assigned to receive percutaneous transhepatic puncture with one-stage rigid choledochoscopy followed by PL for stone removal. All patients were followed-up for six months after operation. Result The operation time, intraoperational blood loss, postoperative ambulation time and hospital stay in the observation group were (132.6±19.8)min, (20.4±4.33)mL, (1.6±0.4)d and (6.6±1.2)d, all significantly less or shorter than [(182.6±19.1)min, (200.6±15.3)mL, (2.5±0.7)d and (9.7±1.4)d, respectively, P＜0.05] in the control group; post-operationally, total serum bilirubin, ALT and AST levels in the observation were (18.6±2.7)μ mol/L, (40.0±3.9)U/L and (38.0±3.7)U/L, all much lower than [(23.6±3.1)μ mol/L, (53.9±4.0)U/L and (49.9±4.0)U/L, respectively, P＜0.05] in the control; incidence of complications, such as incision infection, biliary leakage, biliary bleeding and pleural and peritoneal effusion in the observation group was 13.6%, much lower than 52.0%(P＜0.05) in the control; stone clearance rate was 93.2%, much higher than 60.0%(x²=11.479, P=0.001) in the control ,and six-months after surgery, the stone recurrence rate was 6.8%, much lower than 32.0%(x²=4.899, P=0.027) in the control group. Conclusion Percutaneous transhepatic puncture for one-stage rigid choledochoscopy lithotomy followed by PL in patients with IBDS could significantly improve stone clearance rate and decrease the recurrence rate, which warrants large-scale clinical investigation.

Key words: Intrahepatic bile duct stones, One-stage percutaneous transhepatic rigid choledochoscopy, Pneumatic lithotripsy, Therapy