Bile duct perfusion of Chaihu Paishi Decoction combined with duodenoscopy in treatment of difficult choledocholithiasis

• Main Authors: TANG Tengqian, YANG Zhiqing, LIU Danqing, OU Xia, GAN Lang, ZHANG Leida
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2021-02-01
• Series: Di-san junyi daxue xuebao
• Subjects: chaihu paishi decoction; duodenoscopy; difficult choledocholithiasis
• Online Access: https://aammt.tmmu.edu.cn/Upload/rhtml/202008204.htm

Objective To investigate the clinical efficacy and safety of Chaihu Paishi Decoction through bile duct perfusion combined with duodenoscopy in the treatment of difficult choledocholithiasis. Methods A prospective randomized controlled study was carried out on the patients with difficult choledocholithiasis admitted in our department from August 2018 to January 2020. They were randomly divided into an experimental group and a control group, with 30 cases in each group. In the experimental group, 20~50 mL Chaihu Paishi Decoction was injected into the nasobiliary duct under the guidance of duodenoscopy, and the end of the duct was clamped for 2 h. The above treatment was given 3 times per day, for 10 d. The control group was treated with normal saline in the same way. The stone dissolution, lysis rate and stone remove were observed to evaluate the efficiency. On the 10th day, ultrasound examination was performed, and duodenoscopy was carried out. Results The stone dissolution and lysis rates were significantly higher in the experimental group than those in the control group (P < 0.01). The experimental group had obviously shorter operation time and less blood loss (P < 0.01) and notably higher one-shot stone removal rate (P < 0.05) when compared with the control group. The experimental group did not differ from the other group in the incidence of postoperative acute pancreatitis. Conclusion Chaihu Paishi Decoction through bile duct perfusion combined with duodenoscopy is safe and effective in the treatment of difficult common bile duct stones, which provides a new basis for the treatment in combination with traditional Chinese and Western medicine.