Extra-fine choledochoscope in treating polypoid lesions of gallbladder by percutaneous trans-hepatic and trans-gallbladder puncture / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the therapeutic effect of extra-fine choledochoscope in treating polypoid lesions of gallbladder by percutaneous trans-hepatic and trans-gallbladder puncture(PTGB). Methods Extra-fine choledochoscope(2. 7 mm diameter)was inserted into tract soon after it was made per-cutaneously trans-hepatic and dilated in one session,gallbladder polyps was removed with biopsy forceps or snare or basket,and PTCD drainage tube(10. 2 F diameter)was imbedded for external drainage until 10 days after. If the gallbladder puncture point fell on the bed and gallbladder polyps were not clearly visual-ized,or puncture points were on non-gallbladder bed of the body,drainage tube(10. 2 F diameter)was placed for external drainage. Results Forty-two patients were successfully punctured,and 40 patients were punctured accurately on the bed in,and the fresh endoscope tract of these patients was established in 45 mi-nutes on average. Of the 29 cases of simple bottom and body ventral polyps,complete clearance of gallbladder polyps was achieved in 27. Gallbladder polyps clearance rate was 93. 10%. Complications of minor hemobi-lia occurred in 9 cases,and infection of biliary tract occurred in 3 cases after operation. There was no recur-rence after a follow-up of 15 months on average. Conclusion Extra-fine choledochoscope by PTGB is a less invasive,more reliable and effective method to cure benign polypoid lesions of the gallbladder. The gallblad-der is preserved and for malignant polyps,it can help to achieve early diagnosis and provide reliable evidence for further treatment.