Short and long term results of percutaneous transhepatic cholangioscopic lithotomy in the treatment of intrahepatic duct stones / 中华普通外科杂志

Objective To explore the short and long term curative effects of percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in the treatment of intrahepatic stone (IHS).Methods 38 IHS patients were enrolled,who were treated with PTCSL between January 2008 and July 2013.Results PTCSL was successfully completed in all the 38 IHS cases.Stone clearance rate was 84.2％ and the average episode of stone removal was (2.6 ± 0.9) times.Average diameter of percutaneous transhepatic fistula was (18.4 ± 0.6) F and the average time from percutaneous transhepatic puncture and fistulization to cholangioscopic lithotomy was (7.2 ± 0.7)d.The average operation time was (68 ± 20) min,intraoperative blood loss was (20 ± 13) ml,and hospitalization was (4 ± 2) days.The hepatolith recurrence rate in patients with stones completely removed was 37.5％ (12/32),and 1 case developed into biliary cirrhosis.Patients with calculi residual suffered from higher hepatolith recurrence rate of 83.8％ (5/6),with biliary cirrhosis found in 1 case.Conclusions PTCSL is safe and effective in treating primary IHS,which is indicated in multiple recurrent IHS especially in after biliary surgery patients.It has the advantages of minimally invasion,less bleeding,less postoperative pain,less complications,and fast postoperative recovery.

Percutaneous hepatocholangiostomy in treatment of recurrence hepatobiliary stones / 中国医师进修杂志

Objective To explore the potential predominance and value of percutaneous hepatocholangiostomy (PCH) in treatment of recurrence hepatobiliary stones (RHS). Methods Seventeen cases with RHS were treated by PCH from February 2001 to October 2005, which was an improved technology of percutaneous transhepatic cholangioscopy (PTCS) and made reference to the methods of percutaneous nephrostomy (PCN). Results Seventeen cases were successfully treated. The average blood loss was 40 ml (ranging from 15 to 100 ml), and stones were removed completely in 88.2% (15/17). The average hospital stay was 14 (ranging from 10 to 59) days. No one required postoperative analgesic. No postoperative bleeding and biliary leakage were found. Conclusions PCH has significant advantages of minimal invasion, little blood loss, less pain, less complications and quick recovery in the treatment of RHS.