title: Management complicated hepatolithiasis with operative rigid choledochoscope guided by computed tomography (CT)-based 3D reconstruction technique.
abstract: BACKGROUND
  Treatment of complicated hepatolithiasis is complex and difficult. In this report, we present a novel approach to manage complicated hepatolithiasis using the rigid choledochoscope guided by CT-based 3D reconstruction technique with or without hepatectomy.
  
  
  METHODS
  Between February 2012 to December 2013, 25 patients with complicated hepatolithiasis underwent rigid choledochoscope guided by CT-based 3D reconstruction technique combined with or without hepatectomy. 27 patients with complicated hepatolithiasis underwent a traditional operation (traditional method group) from June 2011 to January 2012. All operations were performed by the authors.
  
  
  RESULTS
  The final stone clearance rate of the rigid choledochoscope group was 96%, whereas that of the traditional method group was 74.1% (P=0.032). There was no patient died of postoperative mortality in two groups. Moreover, the operative time in the traditional method group was significantly longer than that in the rigid choledochoscope group (P=0.010). Recurrent intrahepatic bile duct stones were not found during the follow-up period in the two groups.
  
  
  CONCLUSIONS
  Operative rigid choledochoscope guided by CT-based 3D reconstruction technique combined with or without hepatectomy may be an effective and safe treatment for complicated hepatolithiasis.
authors.forename: Chang-Cheng
authors.initials: CC
authors.lastname: Dong
authors.forename: Chi-Hua
authors.initials: CH
authors.lastname: Fang
authors.forename: Tian-Chong
authors.initials: TC
authors.lastname: Wu
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
authors.forename: Ying-Fang
authors.initials: YF
authors.lastname: Fan
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.forename: Ning
authors.initials: N
authors.lastname: Zeng
authors.forename: Shi-Zhen
authors.initials: SZ
authors.lastname: Zhong
authors.forename: Su-Su
authors.initials: SS
authors.lastname: Bao
mesh_terms: D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019723:Endoscopes; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D006498:Hepatectomy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome