Long-Term Outcome of Percutaneous Transhepatic Cholangioscopic Lithotomy for Hepatolithiasis

• DOI: 10.1111/j.1572-0241.2003.08770.x
• Publication Date: 2004-03-22T14:26:42Z
• Authors: Min-Ho Huang; Chien-Hua Chen; Jee-Chun Yang; Chi-Chieh Yang; Yung-Hsiang Yeh; Der-Aur Chou; Lien-Ray Mo; Sen-Kou Yueh; Chiu-Kuei Nien
• Keywords: Lithotomy position; Hepatolithiasis

OBJECTIVES: Percutaneous transhepatic cholangioscopic lithotomy (PTCSL) for the treatment of hepatolithiasis is particularly suited those patients who are poor surgical risks or refuse surgery and with previous biliary stones distributed in multiple segments. However, characterized by high rates failure recurrence. We examined long-term results 245 treated PTCSL. METHODS: This was a retrospective study underwent PTCSL hepatolithiasis; were followed 1–22 yr to evaluate immediate results. Sonography used search stone recurrence every year whenever presented symptoms suggestive cholangitis. Cholangiography and/or CT performed verify RESULTS: achieved complete clearance 209 (85.3%); rate incomplete higher intrahepatic duct stricture (29/118, 24.6% vs 7/127, 5.5%; p = 0.002). The major complications 1.6% (4/245) included liver laceration (n 2), intra-abdominal abscess 1), disruption percutaneous drainage fistula 1). overall cholangitis 63.2%. absolute not significantly related presence (51/89, 56.2% 53/120, 44.4%; 0.08), although median time less (11 18 yr; 0.007). In without stricture, dilation (34/38, 89.5% 86/89, 96.6%; 0.196), but (20/34, 58.8% 33/86, 38.4%; 0.042). Among successful initial PTCSL, incidence recurrent cholangiocarcinoma incompletely removed than coexisting (44.3%, 27/61 16.2%, 24/148; < 0.001 6.6%, 4/61 0.7%, 1/148; 0.026). CONCLUSIONS: relatively safe effective procedure treating hepatolithiasis. Long-term follow-up required because high. stricture. absence dilated duct. Complete necessary,