The management of complicated hepatolithiasis with intrahepatic biliary stricture by the combination of T-tube tract dilation and endoscopic electrohydraulic lithotripsy.
Hepatolithiasis with intrahepatic biliary strictures, more common in Southeast Asia than elsewhere, remains a difficult problem to manage. Retention of stones behind strictures after surgery is a frequent and troublesome complication. Post-operative duct dilation with percutaneous transhepatic cholangioscopy tube stenting through a matured T-tube tract was performed in 15 patients. Choledochoscopic electrohydraulic lithotripsy was applied in six patients when impacted or large stones were encountered. Complete clearance of stones was achieved in 12 patients (80%). Two patients had fevers develop after ductal dilation and recovered after conservative treatment. These 12 successfully treated patients remain well, with a mean follow-up of 18 months. Post-operative T-tube tract dilation, selectively combined with endoscopic electrohydraulic lithotripsy, is an effective and safe method for complicated hepatolithiasis with biliary strictures.
Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan, Republic of China.
S M
SM
Sheen-Chen
F F
FF
Chou
C M
CM
Lee
Y F
YF
Cheng
T Y
TY
Lee
D000328:Adult; D000368:Aged; D002137:Calculi / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002780:Cholestasis, Intrahepatic / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004106:Dilatation; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents