Is the minimally invasive treatment of liver and bile duct stones effective?

  Laparoscopy combined with cholangioscopy for hepatobiliary stones without surgery relieves patients of intractable stones in the hepatobiliary tract.  Laparoscopy combined with choledochoscopy for hepatobiliary stones: Hepatobiliary stones are one of the common diseases in China, and their condition is complicated and difficult to treat. The treatment of hepatobiliary stones in most hospitals in China still follows the traditional surgical method of open choledochotomy, T-tube drainage and partial resection of liver lobes. While traditional open surgery is used to treat the disease, it is also very traumatic for patients and has a high residual stone rate. The advantage of laparoscopy combined with choledochoscopy for the treatment of hepatic bile duct stones is that laparoscopic surgical instruments can be inserted through 3-5 small holes of 0.5-1.0 cm in the abdominal wall to open the common bile duct, and the choledochoscope can be inserted into the intrahepatic bile duct through the operation orifice of the laparoscope through the common bile duct incision to make a clear diagnosis and remove the stones with a biliary mesh basket.  For those who have more stones and take longer time for intraoperative stone extraction, it is not mandatory to remove them at one time, and the T-tube can be left in place for the second stage of stone extraction through the sinus tract to simplify the first stage of surgery. At the same time, the liver can be observed comprehensively during the operation, and if the liver lobe atrophy is combined, left lobectomy or left hemicolectomy can be added.  After 6-8 weeks postoperatively, second-stage transsinusoidal choledochoscopic stone extraction is performed, especially with the combination of biliary balloon dilation, high-frequency electrodesis, selective bile duct drainage, liquid electrolysis, laser lithotripsy, microblast lithotripsy, etc. The removal rate of many difficult hepatobiliary stones that could not be removed through choledochoscopy in the past is greatly improved, thus avoiding the damage caused by unnecessary liver lobe resection. Through 3-5 small holes of 0.5-1cm in the abdominal wall, the persistent disease of hepatobiliary stones can be cured.