Percutaneous trans-hepatic cholangioscopic lithotomy for hepatolithiasis: long-term results.
A prospective study was undertaken to evaluate the long-term results of percutaneous trans-hepatic cholangioscopic lithotomy in 48 patients with hepatolithiasis during a 4- to 10-year follow-up period. Complete clearance of the intrahepatic stones was achieved in 40 patients (83.3%). In these 40 patients, long-term results during the follow-up period were as follows: free of symptoms and without evidence of recurrent stones, 22 patients (55%); free of symptoms with recurrent stones, 2 patients; recurrent stones with cholangitis, 14 patients (35%); symptoms of cholangitis without evidence of recurrent stones, 2 patients. Of those patients with recurrent stones, secondary biliary cirrhosis developed in 1, and in 9 of the patients in whom secondary cholangitis developed, subsequent laparotomy or percutaneous drainage was required. Three of the 40 patients (7.5%) died within the 4- to 10-year follow-up period. The procedural failure rate in terms of stone retention was 20.5% for patients with bile duct strictures. No stones were retained in patients without strictures. The postprocedural rate of stone recurrence for patients with bile duct strictures was 51.6%; no recurrence was seen in patients without strictures.
Jan
Y Y
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Department of Surgery, Chang Gung Memorial Hospital, Chang Gung College of Medicine & Technology, Taipei, Taiwan, Republic of China.
Chen
M F
MF
D000328:Adult; D001653:Bile Ducts, Intrahepatic; D002761:Cholangitis / Q000209:etiology; D002769:Cholelithiasis / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D002780:Cholestasis, Intrahepatic / Q000209:etiology; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome