Experience on three endoscopic combination and choledochotomy with primary suture in the treatment of choledocholithiasis

doi:10.3969/j.issn.1674-3806.2014.05.13

Abstract：Objective To summarize the experience of combination of laparoscope , choledochoscope , duod-enoscope ( three endoscopic combination ) and choledochotomy with primary suture in the treatment of choledocholithi-asis.Methods Three endoscopic combination and choledochotomy with primary suture were used in 62 patients with choledocholithiasis .Results Stones in 62 patients were successfully removed .At the first day and the third day after operation, the reexamination of liver function and blood , urine amylase showed postoperative alanine aminotransferase (ALT), aspartate aminotransferase(AST), total bilirubin(TBIL) in patients with abnormal liver function before op-eration significantly decreased , no raising blood and urine amylase was found .In one case, postoperative peritoneal drainage showed yellow bile for 3 days.All patients were followed up , the follow-up time were 3~6 months.At 2~8 weeks after operation review of MRCP showed no clear residual stone shadow was found in 62 patients, 5 cases were reported papillary stenosis shadow , but no symptoms and signs , and were not treated .At 3~6 months after operation review of B-type ultrasound showed three cases were reported having bile duct gas accumulation and were not treated . Conclusion The three endoscopic combination and choledochotomy with primary suture in the treatment of choledo -cholithiasis is safe , effective and feasible , and for appropriate cases , it is worthy of promotion .