Evolution of postoperative imaging of the affected bile ducts in patients with intra- and extrahepatic stones

Objective: To determine therapeutic e cacy in patients with intra-and extrahepatic stones by observation of the imaging evolution of the a ected bile ducts before and a er operation.Methods: e clinical records of 62 patients with intra-and extrahepatic calculi who met the criteria between 2006 to 2009 were selected,and then the patients were followed up and reexamined with MRI and magnetic resonance cholangiopancreatography(MRCP).e patients were divided,according to the types of surgery performed,into group A(8 cases,undergoing choledocholithotomy,T-tube drainage and partial liver resection),group B(16 cases,undergoing choledocholithotomy,T-tube drainage,partial liver resection,and choledochoscopic lithotomy via T-tube sinus tract) and group C(38 cases,undergoing choledocholithotomy,T-tube drainage,and choledochoscopic lithotomy via T-tube sinus tract).The imaging evolutions of each group were observed.e disease characteristic factors were assigned weighted values,according to which the scores of each group before and a er operation were calculated to assess the therapeutic e ects.Results: In the entire group,the pre-and postoperative rate of intrahepatic bile duct dilatation,extrahepatic bile duct dilatation and intrahepatic bile duct stricture was 98.4% vs.79.0%,90.3% vs.67.7%,and 40.3% vs.29.0% respectively,and recurrence rate was 9.7%.By comparison of the results before and a er operation,the maximal diameters of the common bile duct in the three groups were all signi cantly reduced(all P0.05),and the maximal diameters of the intrahepatic bile duct in group B and group C were markedly decreased(both P0.05),and except in group A,it did not reach statistical significance(P0.05).The postoperative scores in the three groups were all signi cantly decreased(all P0.05),and the results of the pairwised comparison showed that the di erence-value between pre-and postoperative scores in group B was signi cantly higher than that in group C(P0.05).Conclusion: Most of the affected intra-and extrahepatic bile ducts do not recover into their normal state after operation and choledochoscopic lithotomy.Partial hepatectomy is an ideal procedure for intra-and extrahepatic stones.