Effect of percutaneous transhepatic one-step biliary fistulation combined with rigid choledochoscopy in the treatment of benign hepatic bile duct strictures / 中华肝胆外科杂志

Objective:To investigate the therapeutic effect of percutaneous transhepatic one-step biliary fistulation (PTOBF) combined with rigid choledochoscopy in the treatment of benign hepatic bile duct strictures.Methods:The clinical data of 46 patients with hepatic ductal stenosis and stones undergoing PTOBF combined with rigid choledochoscopy at the First Hospital of Guangzhou Medical University between September 2016 and September 2022 were retrospectively analyzed, including 20 males and 26 females, aged (48.5±17.6) years. The location of stones and strictures, stone retrieval rate, postoperative complications, stricture release rate, stone recurrence rate, and reoperation rate were analyzed to access the safety and effectiveness of this procedure.Results:A total of 58 sites of stenoses were found in 46 patients, and PTOBF lithotripsy combined with rigid choledochoscopy were performed for 77 times. The early postoperative complication rate was 19.6% (9/46), and the stenosis release rate was 93.5% (43/46). The mean follow-up time was (28.1±19.6) months, the complete stone retrieval rate was 91.3% (42/46), the stone recurrence rate was 19.6% (9/46), the reoperation rate was 8.7% (4/46), and the long-term postoperative complication rate was 6.5% (3/46).Conclusion:PTOBF combined with rigid choledochoscopic stenoplasty for benign hepatic duct strictures is a safe and feasible procedure to reduce the stone recurrence and long-term postoperative complications.

Progress in surgical treatment of hepatolithiasis associated with bile duct strictures / 中华肝胆外科杂志

Hepatolithiasis refers to a disease with stones located in bile ducts above the bifurcation of the left and right hepatic ducts. It is a common benign biliary duct disease. Hepatolithiasis is often associated with intrahepatic bile duct strictures. Due to its complex etiology and pathological changes, its treatment remains a hot topic for debate and research in biliary surgery. In recent years, new treatments have been introduced, but they are all faced with problems such as high recurrence rate, postoperative restenosis rate and reoperation rate. This article reviews the recent progress of surgical management of biliary strictures in the treatment of hepatolithiasis, including the use of hepatectomy, biliary plastic surgery, choledochoenterostomy, choledochoscopy and endoscopic retrograde cholangiopancreatography biliary stent placement to provide a up-to-date view surgical treatment of hepatolithiasis associated with biliary strictures.