Hiệu quả và an toàn của phẫu thuật nội soi kết hợp soi đường mật trong mổ điều trị sỏi đường mật chính tại Bệnh viện Quân y 175

Abstract

Objective: Evaluation of the efficacy and safety of laparoscopic surgery combined with intraoperative choledochoscopy for stone extraction in the treatment of common bile duct stones at Military Hospital 175. Subject and method: A cross-sectional descriptive study was conducted on 69 patients who underwent laparoscopic surgery combined with intraoperative choledochoscopy at the Department of Abdominal Surgery, Military Hospital 175, from August 2025 to April 2026. Result: The mean age was 58.2 ± 16.9 years, with a female-to-male ratio of 2.45:1. Concomitant medical comorbidities were present in 47.8% of patients. Charcot’s triad was observed in 26.1% of cases; 98.6% presented with right upper quadrant pain, 42.0% with fever, and 49.3% with jaundice. Stone extraction techniques included basket retrieval alone or in combination with endoscopic instruments, electrohydraulic lithotripsy, Randall forceps, or a combination of these methods. Concomitant cholecystectomy was performed in 62.3% of patients. Complete stone clearance was achieved in 82.6% of cases, while 17.4% had residual intrahepatic stones that were subsequently treated by lithotripsy via the Kehr tract. The intraoperative complication rate was 2.9%, and the postoperative complication rate was 5.8%. Surgical outcomes were classified as good in 78.3% of patients, fair in 18.8%, and average in 2.9%; no poor outcomes were recorded. Conclusion: Laparoscopic surgery combined with intraoperative choledochoscopy for the removal of common bile duct stones is a safe and effective treatment modality, achieving a high stone clearance rate with low rates of intraoperative and postoperative complications.