title: Choledochoscopic lithotripsy is a useful adjunct to laparoscopic common bile duct exploration for hepatolithiasis: a cohort study.
abstract: BACKGROUND
  This study aims to investigate the role of combining choledochoscopic lithotripsy with laparoscopic common bile duct exploration for hepatolithiasis in patients who are not suitable for hepatectomy.
  
  
  METHODS
  From March 2009 to March 2013, 86 patients with hepatolithiasis irrespective of whether they underwent a choledochoscopic plasma shock wave lithotripsy or not were analyzed.
  
  
  RESULTS
  Sixty-two patients underwent lithotripsy and 24 patients underwent basket lithoextraction intraoperatively. Plasma shock wave lithotripsy did not lengthen the operating time, but decreased the postoperative residual stone rate and reduced the frequency of postoperative choledochoscopic lithotomy for patients with remnant stones. The overall final stone clearance rate was 98.8%. During a mean follow-up of 26.2 months, recurrent stones and cholangiocarcinoma developed in 1 patient, respectively.
  
  
  CONCLUSIONS
  Laparoscopic common bile duct exploration combined with choledochoscopic lithotripsy is a definitive procedure for hepatolithiasis in patients who are not candidates for hepatectomy.
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China. Electronic address: puqingfan@sina.com.
authors.forename: Qingfan
authors.initials: Q
authors.lastname: Pu
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Chuanrong
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Ruifang
authors.initials: R
authors.lastname: Ren
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Zhenfeng
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Jin
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Gaojian
authors.initials: G
authors.lastname: Cao
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Minghui
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Wenzhou University of Medical Science, No. 108, Wansong Road, Ruian 325200, China.
authors.forename: Weijiang
authors.initials: W
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Bile duct exploration; Hepatolithiasis; Laparoscopy; Lithotripsy