Objective  To investigate the effect of percutaneous transhepatic choledochoscopic lithotomy (PTCSL) in treatment of hepatolithiasis guided by soft fiber-optic choledochoscope (SFCS).

  Methods  A total of 129 patients with PTCSL were selected, including 57 patients with conventional PTCSL and 72 patients with PTCSL guided by SFCS. Patients were divided into SFCS group (n=72) and conventional group (n=57) according to differed treatment methods. Propensity score matching method was used to balance the baseline indicators of patients in the two groups. After matching, there were 51 patients in each group. Operation time, blood loss, postoperative bowel sound recovery time, defecation time, postoperative hospital stay and stone recurrence rate were compared between the two groups.

  Results  The amount of intraoperative blood loss in the SFCS group was significantly less, the operation time, postoperative hospital stay, postoperative bowel sound recovery time and defecation time were significantly shorter than those in the conventional group (P < 0.05). The postoperative recurrence rate of the SFCS group was lower than that of the conventional group.

  Conclusion  The new SFCS has the advantages of clear field of vision, slim lens, flexible lens as well as convenient operation, and it can be combined with cold laser lithotripzer. PTCSL guided by SFCS is safe and effective in the treatment of patients with hepatolithiasis.