Application of three-dimensional visualization technology on one-step PTCSL for complex hepatolithiasis.

Area of Science:

• Hepatobiliary surgery
• Minimally invasive procedures
• Medical imaging technology

Background:

• Hepatolithiasis treatment, particularly one-step percutaneous transhepatic cholangioscopic lithotripsy (PTCSL), remains challenging.
• Intrahepatic bile duct stones require effective and safe therapeutic strategies.

Purpose of the Study:

• To evaluate the impact of three-dimensional (3D) visualization on one-step PTCSL for hepatolithiasis.
• To compare perioperative and long-term clinical outcomes between PTCSL with and without 3D assistance.

Main Methods:

• Retrospective analysis of 231 hepatolithiasis patients from January 2015 to January 2019.
• Group A (139 patients) underwent one-step PTCSL with 3D visualization.
• Group B (92 patients) underwent one-step PTCSL alone.

Main Results:

• One-step PTCSL with 3D visualization showed a slight reduction in intraoperative blood loss (21.14 ± 17.91 ml vs. 21.47 ± 25.91 ml) and hospital stay (12.21 ± 6.14 days vs. 18.77 ± 8.73 days).
• No significant differences were observed in hospitalization expenses, final stone clearance rates, or postoperative complications between the groups.
• Recurrence-free survival (RFS) data was also analyzed for long-term outcomes.

Conclusions:

• Three-dimensional (3D) visualization improves the safety and effectiveness of one-step PTCSL for complicated primary hepatolithiasis.
• The technique demonstrates promising perioperative and long-term outcomes for patients with complex intrahepatic bile duct stones.