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A clinical study of choledochoscopic holmium laser lithotripsy for multiple intrahepatic calculi within ERAS programs
Lasers in surgery and medicine, 2019-02, Vol.51 (2), p.161-166
Wang, Cheng
Lv, Shangdong
Wang, Aidong
Zhang, Fabiao
Wang, Binfeng
Xu, Yongfu
Zhu, Yu
Fang, Zheping
2019
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Wang, Cheng
Lv, Shangdong
Wang, Aidong
Zhang, Fabiao
Wang, Binfeng
Xu, Yongfu
Zhu, Yu
Fang, Zheping
Titel
A clinical study of choledochoscopic holmium laser lithotripsy for multiple intrahepatic calculi within ERAS programs
Ist Teil von
Lasers in surgery and medicine, 2019-02, Vol.51 (2), p.161-166
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2019
Quelle
Wiley Online Library All Journals
Beschreibungen/Notizen
Objectives Multiple intrahepatic calculi, especially calculi in both sides of the liver, cannot be completely resolved by traditional surgery. In addition, morbidity after liver resection remains high. ERAS programs have been suggested that could relieve surgical stress and accelerate postoperative recovery. This study aimed to evaluate the safety and efficacy of choledocholithotomy combined with holmium laser lithotripsy in the treatment of multiple intrahepatic calculi within ERAS programs. Methods In all, 109 patients with multiple intrahepatic calculi were enrolled between January 2012 and September 2016, 42 of whom received choledocholithotomy combined with holmium laser lithotripsy. The remaining 67 patients underwent choledocholithotomy combined with choledochoscopic mechanical lithotripsy. Perioperative outcomes were compared and analyzed. Results Patient characteristics and preoperative details were similar between the groups (P > 0.05). The implementation of holmium laser lithotripsy could reduce the calculi residual rate (7.1% vs. 22.4%, P = 0.037), and even the liver resection rate (16.7% vs. 35.8%, P = 0.031). Additionally, holmium laser lithotripsy did not result in a higher morbidity (11.9% vs. 16.4%, P = 0.517), readmission rate (0% vs. 6%, P = 0.158), hospital stay (P = 0.189), hospital cost (P = 0.998), transfusion rate (P = 0.576), or operative time (P = 0.638). Conclusions Holmium laser lithotripsy is feasible and efficient for treating multiple intrahepatic calculi within ERAS programs, which could reduce the liver resection rate and render refractory hepatic calculi easy to eliminate. In addition, holmium laser lithotripsy could be well coupled to the ERAS program to relieve surgical stress and accelerate postoperative recovery. Lasers Surg. Med. 51:161–166, 2019. © 2018 Wiley Periodicals, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 0196-8092
eISSN: 1096-9101
DOI: 10.1002/lsm.23004
Titel-ID: cdi_proquest_miscellaneous_2072192963
Format
–
Schlagworte
Calculi
,
Choledocholithiasis - diagnostic imaging
,
Choledocholithiasis - surgery
,
Choledocholithiasis - therapy
,
choledocholithotomy
,
choledochoscopy
,
Combined Modality Therapy
,
ERAS programs
,
Female
,
Holmium
,
holmium laser
,
Hospital costs
,
Humans
,
intrahepatic calculi
,
Lasers
,
Lithotripsy
,
Lithotripsy, Laser - instrumentation
,
Lithotripsy, Laser - methods
,
Liver
,
Liver Diseases - diagnostic imaging
,
Liver Diseases - surgery
,
Liver Diseases - therapy
,
Male
,
Middle Aged
,
Morbidity
,
Patients
,
Recovery
,
Retrospective Studies
,
Surgery
,
Transfusion
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