Objective: To evaluate the results of laparoscopic choledochotomy combined with intraoperative flexible choledochoscopy for the treatment of primary bile duct stones at Military Hospital 103. Patient and methods: Descriptive, retrospective and prospective, non-controlled research on patients with primary bile duct stones treated by laparoscopic choledochotomy combined with intraoperative flexible choledochoscopy at the Abdominal surgery centre - Military hospital 103 from May 2022 to December 2025. Results: Study on 152 patients. Average age: 59.57 ± 12.31; Female/male ratio = 1.38/1; 47.4% of patients had a history of biliary stone. Multiple stones accounted for the majority (80.3%) and were present simultaneously in both the intrahepatic and extrahepatic bile ducts with diverse morphology. Stone removal methods were done by Mirizi forceps and basket; stone lithotripsies were electrohydraulic and laser. The overall stone clearance rate was 86.2%, and the remaining stone rate was 13.8%. The ratio of intraoperative complications was 5.9%, and postoperative complications were 9.9%. Postoperative outcome classification showed that 86.2% had good results, and there were no deaths or severe complications requiring reoperation. Conclusion: Laparoscopic choledochotomy combined with intraoperative flexible choledochoscopy is initially a safe and effective method for treating primary bile duct stones. This method has a high rate of stone clearance and a low rate of complications.
RESULTS OF laparoscopic choledochotomy COMBINED WITH intraoperative FLEXIBLE cholEDOCHOscopy FOR THE TREATMENT OF PRIMARY BILE DUCT STONES
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Keywords
Laparoscopic choledochotomy, Intraoperative flexible choledochoscopy, Primary bile duct stones.
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References
[1]
1. Võ Đại Dũng, Nguyễn Trung Hiếu, Trịnh Du Dương (2021). Kết quả phẫu thuật nội soi điều trị sỏi trong gan tại Bệnh viện Trưng Vương. Y Học TP. Hồ Chí Minh; 25(1): 155-161.
Google Scholar
[2]
2. La Văn Phú, Phạm Văn Linh, Võ Huỳnh Trang (2022). Kết quả điều trị sỏi đường mật chính bằng PTNS kết hợp NSĐM trong mổ. Tạp chí y dược học Cần Thơ; 45: 206-213.
Google Scholar
[3]
3. Angsuwatcharakon, P., Kulpatcharapong, S., Moon, J. H., Ramchandani, M., Lau, J., Isayama, H., & Rerknimitr, R. (2022). Consensus guidelines on the role of Choledochoscopy to diagnose indeterminate biliary stricture. International Hepato-pancreato-billiary-association journal; 24(1), 17-29.
Google Scholar
[4]
4. Phạm Văn Cường (2012). Đặc điểm lâm sàng, cận lâm sàng và kết quả sớm điều trị phẫu thuật sỏi trong gan tại Bệnh viện Việt Đức. Y học thực hành; 813(3): 50-54.
Google Scholar
[5]
5. Chen C. H., Huang M. H., Yang J. C., et al (2015). Reappraisal of percutaneous transhepatic cholangioscopic lithotomy for primary hepatolithiasis. Surg Endosc; 19: 505-509.
Google Scholar
[6]
6. Loi Van Le, Quang Van Vu, Thanh Van Le. et al (2024). Outcomes of laparoscopic laparoscopic choledochotomy usingCholedochoscopy via percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis: A preliminary Vietnamese study. Ann Hepatobiliary Pancreat Surg; 28:42-47
Google Scholar
[7]
7. Lê Nguyên Khôi, Đoàn Văn Trân (2010). Hiệu quả của phẫu thuật ít xâm hại trong điều trị sỏi đường mật chính. Y học TP. Hồ Chí Minh; 14(2): 1-8.
Google Scholar
[8]
8. Buxbaum J., Sahakian A., Ko C., et al (2018). Randomized trial of Choledochoscopy-guided laser lithotripsy versus conventional therapy for large bile duct stones. Gastrointestinal Endoscopy; 87(4): 1050-1060.
Google Scholar
[9]
9. Shojaiefard A., Khorgami Z., Ghafouri A., et al (2014). Outcome of Common Bile Duct Exploration without Intraoperative Cholangiography: a Case Series and Review of Literature. Acad J Surg; 1(2): 60-65.
Google Scholar
[10]
10. Lê Quan Anh Tuấn (2021). Điều trị sỏi đường mật trong gan qua đường hầm ống Kehr bằng ống soi mềm. Luận án tiến sĩ y học. Đại học y dược TP Hồ Chí Minh.
Google Scholar