Applied rigid choledochoscope and pneumatic lithotripsy in targeting treatment of hepatolithiasis guided by three-dimensional visualization technology

Objective: To study the value of rigid choledochoscope and pneumatic lithotripsy in targeting treatment of hepatolithiasis under the guidance of three-dimensional visualization technology.

Methods: The 26 patients with hepatolithiasis from February 2012 to June 2013 were analyzed. There were 11 male and 15 female patients with a median age of 55.2 years (range 31-75 years old). The image data of CT scanning of hepatolithiasis were introduced into medical image three-dimensional visualization system (MI-3DVS) for three-dimensional reconstruction, 3D classifications of hepatolithiasis were obtained based on it. Applied rigid choledochoscope and pneumatic lithotripsy in targeting treatment of hepatolithiasis guided by three-dimensional visualization technology.

Results: The 26 patients (29 times) experienced targeting treatment of rigid choledochoscope and pneumatic lithotripsy under the guidance of three-dimensional visualization technology, including:19 cases (4 cases of type IIc) through percutaneous biliary tract sinus, laparoscopic surgery 3 cases, laparotomy 4 cases. Three patients underwent surgery twice. The final stone clearance rate was 100%.One case confirmed combined with cholangiocarcinoma and transfer to radical resection.Intraoperative blood loss was (41.7 ± 8.5) ml, operating time was (100.8 ± 7.6) minutes, and postoperative hospital stay was (7.0 ± 0.6) days. A patient suffered postoperative biliary tract bleeding.Without bile duct injury, bleeding, bile leakage and other complications were occurred.

Conclusions: Rigid choledochoscope and pneumatic lithotripsy in the treatment of hepatolithiasis under the guidance of three-dimensional visualization technology achieved digital minimally invasive treatment of hepatolithiasis, which can be a new approach to hepatobiliary surgery.