Application of ultrasound-guided percutaneous transhepatic cholangioscopy in treatment of complicated hepatolithiasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TAO Jie , DU Zhilin , ZHANG Dong , BAI Jigang , GENG Zhimin ,  SHI Lei

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, P. R. China;

Corresponding author：

SHI Lei, Email: 1215448013@qq.com

Keywords：

hepatolithiasis; percutaneous transhepatic cholangioscopy; lithotomy

DOI：

10.7507/1007-9424.201801043

Video：

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Objective To investigate feasibility and curative effect of ultrasound-guided percutaneous transhepatic cholangioscopy in treatment of complicated hepatolithiasis. Methods The data of 42 patients with complicated hepatolithiasis from June 2012 to June 2017 in the Hepatobiliary Surgery, the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively analyzed. All the patients were treated with ultrasound-guided percutaneous transhepatic cholangioscopy, including the first stage of dilation and drainage and the second stage choledochoscopy. Results The operations of the 42 patients were successfully performed. No case was converted to the conventional laparotomy. The puncture sites of 10 cases were at the right intrahepatic bile duct, 25 cases were at the left intrahepatic bile duct, and 7 cases were at the bilateral intrahepatic bile duct. The residual stones were removed by two stage choledochoscopy in the 31 patients, 11 patients had the residual stones. After the first stage, there were 4 cases of the bile duct hemorrhage, 8 cases of the cholangitis, 1 case of the pleural effusion and 1 case of the infection, 2 cases of the postoperative drainage tube shedding. After the second stage, there were 3 cases of the cholangitis and 3 cases of the postoperative drainage tube shedding. The stones of the 10/31 patients with stone removal occurred and the diseases of 9/11 patients with stone residual were stable during the following-up of (18.6±7.8) months. Conclusion Ultrasound-guided percutaneous transhepatic cholangioscopy including the first stage of dilation and drainage plus the second stage choledochoscopy is safe and effective in treatment of complex intrahepatic bile duct stones, it is an effective supplement to traditional surgery.

Citation： TAO Jie, DU Zhilin, ZHANG Dong, BAI Jigang, GENG Zhimin, SHI Lei. Application of ultrasound-guided percutaneous transhepatic cholangioscopy in treatment of complicated hepatolithiasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(9): 1094-1098. doi: 10.7507/1007-9424.201801043 Copy

1.	陈江明, 耿小平. 肝内胆管结石外科治疗中的困惑. 肝胆外科杂志, 2017, 25(3): 164-167.
2.	陈平, 皮儒先. 肝内胆管结石的外科治疗研究进展. 中国普外基础与临床杂志, 2014, 21(10): 1192-1193.
3.	程南生, 李富宇, 程瑶, 等. 肝胆管结石的外科治疗现状及展望. 中国普外基础与临床杂志, 2014, 21(10): 1185-1188.
4.	张宝善, 山川达郎, 三芳端. 经皮经肝胆道镜的临床应用. 中华外科杂志, 1985, 23(6): 353-355.
5.	Ahmed S, Schlachter TR, Hong K. Percutaneous transhepatic cholangioscopy. Tech Vasc Interv Radiol, 2015, 18(4): 201-209.
6.	Kim EH, Kim HJ, Oh HC, et al. The usefulness of percutaneous transhepatic cholangioscopy for identifying malignancies in distal common [corrected] bile duct strictures. J Korean Med Sci, 2008, 23(4): 579-585.
7.	杨国春, 陈洪刚, 刘其飞, 等. 经皮经肝胆道镜取石术治疗肝内胆管结石的有效性及安全性分析. 中国普外基础与临床杂志, 2017, 24(8): 987-991.
8.	彭沙沙, 郭浚, 裴斐, 等. 腹腔镜肝左外叶切除术中经肝断面胆道镜探查取石治疗肝胆管结石的临床研究. 中国普外基础与临床杂志, 2017, 24(11): 1357-1360.
9.	董家鸿, 黄志强, 蔡景修, 等. 规则性肝段切除术治疗肝内胆管结石病. 中华普通外科杂志, 2002, 17(7): 418-420.
10.	Zhang Z, Liu Z, Liu L, et al. Strategies of minimally invasive treatment for intrahepatic and extrahepatic bile duct stones. Front Med, 2017, 11(4): 576-589.
11.	Yang T, Lau WY, Lai EC, et al. Hepatectomy for bilateral primary hepatolithiasis: a cohort study. Ann Surg, 2010, 251(1): 84-90.
12.	Lin CC, Lin PY, Ko CJ, et al. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg, 2013, 83(12): 978-984.
13.	Takada T, Kobayashi S, Yamada A, et al. A new technique for the diagnosis and therapy of cholangitic hepatic abscesses; percutaneous transhepatic cholangial drainage (auther’s transl). Nihon Shokakibyo Gakkai Zasshi, 1974, 71(7): 657-665.
14.	何炼图, 汤庆, 陈绮璐, 等. 超声引导在经皮肝胆道镜治疗肝胆管结石中的应用. 中华生物医学工程杂志, 2015, 21(1): 81-83.
15.	Huang MH, Chen CH, Yang JC, et al. Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis. Am J Gastroenterol, 2003, 98(12): 2655-2662.
16.	贾捷鹏, 张继军, 邵泉, 等. PTCS 在胆肠吻合术后肝内胆管结石中的应用研究. 中国临床实用医学, 2017, 8(2): 66-67.
17.	梁志鹏, 高焱明, 王和鑫, 等. 左肝外叶径路硬质经皮胆镜治疗原发性肝内胆管结石 30 例报告. 普外基础与临床杂志, 1996, 3(2): 90-92.
18.	蒋小峰, 张大伟, 卢海武, 等. 经皮经肝胆道镜硬镜碎石术治疗肝内胆管结石 194 例临床疗效分析. 中国实用外科杂志, 2017, 37(8): 896-899.
19.	楼健颖, 陈伟, 王冀, 等. 一期扩张法经皮经肝胆道镜在肝内外胆管结石治疗中的应用(附 35 例报告). 中国实用外科杂志, 2017, 37(8): 892-895.
20.	Soares KC, Kamel I, Cosgrove DP, et al. Hilar cholangiocarcinoma: diagnosis, treatment options, and management. Hepatobiliary Surg Nutr, 2014, 3(1): 18-34.
21.	徐恕, 张剑权, 符国珍, 等. 经皮肝穿刺胆管造瘘电子胆道镜取石术治疗肝内胆管结石的近远期疗效. 中华普通外科杂志, 2016, 31(3): 212-214.
22.	Chen C, Huang M, Yang J, et al. Reappraisal of percutaneous transhepatic cholangioscopic lithotomy for primary hepatolithiasis. Surg Endosc, 2005, 19(4): 505-509.
23.	Lee SK, Seo DW, Myung SJ, et al. Percutaneous transhepatic cholangioscopic treatment for hepatolithiasis: an evaluation of long-term results and risk factors for recurrence. Gastrointest Endosc, 2001, 53(3): 318-323.
24.	Oh HC. Percutaneous transhepatic cholangioscopy in bilioenteric anastomosis stricture. Clin Endosc, 2016, 49(6): 530-532.
25.	Voaklander R, Kim E, Brown WH, et al. An overview of the evolution of direct cholangioscopy techniques for diagnosis and therapy. Gastroenterol Hepatol (NY), 2016, 12(7): 433-437.

1. 陈江明, 耿小平. 肝内胆管结石外科治疗中的困惑. 肝胆外科杂志, 2017, 25(3): 164-167.
2. 陈平, 皮儒先. 肝内胆管结石的外科治疗研究进展. 中国普外基础与临床杂志, 2014, 21(10): 1192-1193.
3. 程南生, 李富宇, 程瑶, 等. 肝胆管结石的外科治疗现状及展望. 中国普外基础与临床杂志, 2014, 21(10): 1185-1188.
4. 张宝善, 山川达郎, 三芳端. 经皮经肝胆道镜的临床应用. 中华外科杂志, 1985, 23(6): 353-355.
5. Ahmed S, Schlachter TR, Hong K. Percutaneous transhepatic cholangioscopy. Tech Vasc Interv Radiol, 2015, 18(4): 201-209.
6. Kim EH, Kim HJ, Oh HC, et al. The usefulness of percutaneous transhepatic cholangioscopy for identifying malignancies in distal common [corrected] bile duct strictures. J Korean Med Sci, 2008, 23(4): 579-585.
7. 杨国春, 陈洪刚, 刘其飞, 等. 经皮经肝胆道镜取石术治疗肝内胆管结石的有效性及安全性分析. 中国普外基础与临床杂志, 2017, 24(8): 987-991.
8. 彭沙沙, 郭浚, 裴斐, 等. 腹腔镜肝左外叶切除术中经肝断面胆道镜探查取石治疗肝胆管结石的临床研究. 中国普外基础与临床杂志, 2017, 24(11): 1357-1360.
9. 董家鸿, 黄志强, 蔡景修, 等. 规则性肝段切除术治疗肝内胆管结石病. 中华普通外科杂志, 2002, 17(7): 418-420.
10. Zhang Z, Liu Z, Liu L, et al. Strategies of minimally invasive treatment for intrahepatic and extrahepatic bile duct stones. Front Med, 2017, 11(4): 576-589.
11. Yang T, Lau WY, Lai EC, et al. Hepatectomy for bilateral primary hepatolithiasis: a cohort study. Ann Surg, 2010, 251(1): 84-90.
12. Lin CC, Lin PY, Ko CJ, et al. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg, 2013, 83(12): 978-984.
13. Takada T, Kobayashi S, Yamada A, et al. A new technique for the diagnosis and therapy of cholangitic hepatic abscesses; percutaneous transhepatic cholangial drainage (auther’s transl). Nihon Shokakibyo Gakkai Zasshi, 1974, 71(7): 657-665.
14. 何炼图, 汤庆, 陈绮璐, 等. 超声引导在经皮肝胆道镜治疗肝胆管结石中的应用. 中华生物医学工程杂志, 2015, 21(1): 81-83.
15. Huang MH, Chen CH, Yang JC, et al. Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis. Am J Gastroenterol, 2003, 98(12): 2655-2662.
16. 贾捷鹏, 张继军, 邵泉, 等. PTCS 在胆肠吻合术后肝内胆管结石中的应用研究. 中国临床实用医学, 2017, 8(2): 66-67.
17. 梁志鹏, 高焱明, 王和鑫, 等. 左肝外叶径路硬质经皮胆镜治疗原发性肝内胆管结石 30 例报告. 普外基础与临床杂志, 1996, 3(2): 90-92.
18. 蒋小峰, 张大伟, 卢海武, 等. 经皮经肝胆道镜硬镜碎石术治疗肝内胆管结石 194 例临床疗效分析. 中国实用外科杂志, 2017, 37(8): 896-899.
19. 楼健颖, 陈伟, 王冀, 等. 一期扩张法经皮经肝胆道镜在肝内外胆管结石治疗中的应用(附 35 例报告). 中国实用外科杂志, 2017, 37(8): 892-895.
20. Soares KC, Kamel I, Cosgrove DP, et al. Hilar cholangiocarcinoma: diagnosis, treatment options, and management. Hepatobiliary Surg Nutr, 2014, 3(1): 18-34.
21. 徐恕, 张剑权, 符国珍, 等. 经皮肝穿刺胆管造瘘电子胆道镜取石术治疗肝内胆管结石的近远期疗效. 中华普通外科杂志, 2016, 31(3): 212-214.
22. Chen C, Huang M, Yang J, et al. Reappraisal of percutaneous transhepatic cholangioscopic lithotomy for primary hepatolithiasis. Surg Endosc, 2005, 19(4): 505-509.
23. Lee SK, Seo DW, Myung SJ, et al. Percutaneous transhepatic cholangioscopic treatment for hepatolithiasis: an evaluation of long-term results and risk factors for recurrence. Gastrointest Endosc, 2001, 53(3): 318-323.
24. Oh HC. Percutaneous transhepatic cholangioscopy in bilioenteric anastomosis stricture. Clin Endosc, 2016, 49(6): 530-532.
25. Voaklander R, Kim E, Brown WH, et al. An overview of the evolution of direct cholangioscopy techniques for diagnosis and therapy. Gastroenterol Hepatol (NY), 2016, 12(7): 433-437.

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Application of ultrasound-guided percutaneous transhepatic cholangioscopy in treatment of complicated hepatolithiasis

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