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.	陳江明, 耿小平. 肝內膽管結石外科治療中的困惑. 肝膽外科雜志, 2017, 25(3): 164-167.
2.	陳平, 皮儒先. 肝內膽管結石的外科治療研究進展. 中國普外基礎與臨床雜志, 2014, 21(10): 1192-1193.
3.	程南生, 李富宇, 程瑤, 等. 肝膽管結石的外科治療現狀及展望. 中國普外基礎與臨床雜志, 2014, 21(10): 1185-1188.
4.	張寶善, 山川達郎, 三芳端. 經皮經肝膽道鏡的臨床應用. 中華外科雜志, 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.	楊國春, 陳洪剛, 劉其飛, 等. 經皮經肝膽道鏡取石術治療肝內膽管結石的有效性及安全性分析. 中國普外基礎與臨床雜志, 2017, 24(8): 987-991.
8.	彭沙沙, 郭浚, 裴斐, 等. 腹腔鏡肝左外葉切除術中經肝斷面膽道鏡探查取石治療肝膽管結石的臨床研究. 中國普外基礎與臨床雜志, 2017, 24(11): 1357-1360.
9.	董家鴻, 黃志強, 蔡景修, 等. 規則性肝段切除術治療肝內膽管結石病. 中華普通外科雜志, 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.	何煉圖, 湯慶, 陳綺璐, 等. 超聲引導在經皮肝膽道鏡治療肝膽管結石中的應用. 中華生物醫學工程雜志, 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.	賈捷鵬, 張繼軍, 邵泉, 等. PTCS 在膽腸吻合術后肝內膽管結石中的應用研究. 中國臨床實用醫學, 2017, 8(2): 66-67.
17.	梁志鵬, 高焱明, 王和鑫, 等. 左肝外葉徑路硬質經皮膽鏡治療原發性肝內膽管結石 30 例報告. 普外基礎與臨床雜志, 1996, 3(2): 90-92.
18.	蔣小峰, 張大偉, 盧海武, 等. 經皮經肝膽道鏡硬鏡碎石術治療肝內膽管結石 194 例臨床療效分析. 中國實用外科雜志, 2017, 37(8): 896-899.
19.	樓健穎, 陳偉, 王冀, 等. 一期擴張法經皮經肝膽道鏡在肝內外膽管結石治療中的應用(附 35 例報告). 中國實用外科雜志, 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, 張劍權, 符國珍, 等. 經皮肝穿刺膽管造瘺電子膽道鏡取石術治療肝內膽管結石的近遠期療效. 中華普通外科雜志, 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. 陳江明, 耿小平. 肝內膽管結石外科治療中的困惑. 肝膽外科雜志, 2017, 25(3): 164-167.
2. 陳平, 皮儒先. 肝內膽管結石的外科治療研究進展. 中國普外基礎與臨床雜志, 2014, 21(10): 1192-1193.
3. 程南生, 李富宇, 程瑤, 等. 肝膽管結石的外科治療現狀及展望. 中國普外基礎與臨床雜志, 2014, 21(10): 1185-1188.
4. 張寶善, 山川達郎, 三芳端. 經皮經肝膽道鏡的臨床應用. 中華外科雜志, 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. 楊國春, 陳洪剛, 劉其飛, 等. 經皮經肝膽道鏡取石術治療肝內膽管結石的有效性及安全性分析. 中國普外基礎與臨床雜志, 2017, 24(8): 987-991.
8. 彭沙沙, 郭浚, 裴斐, 等. 腹腔鏡肝左外葉切除術中經肝斷面膽道鏡探查取石治療肝膽管結石的臨床研究. 中國普外基礎與臨床雜志, 2017, 24(11): 1357-1360.
9. 董家鴻, 黃志強, 蔡景修, 等. 規則性肝段切除術治療肝內膽管結石病. 中華普通外科雜志, 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. 何煉圖, 湯慶, 陳綺璐, 等. 超聲引導在經皮肝膽道鏡治療肝膽管結石中的應用. 中華生物醫學工程雜志, 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. 賈捷鵬, 張繼軍, 邵泉, 等. PTCS 在膽腸吻合術后肝內膽管結石中的應用研究. 中國臨床實用醫學, 2017, 8(2): 66-67.
17. 梁志鵬, 高焱明, 王和鑫, 等. 左肝外葉徑路硬質經皮膽鏡治療原發性肝內膽管結石 30 例報告. 普外基礎與臨床雜志, 1996, 3(2): 90-92.
18. 蔣小峰, 張大偉, 盧海武, 等. 經皮經肝膽道鏡硬鏡碎石術治療肝內膽管結石 194 例臨床療效分析. 中國實用外科雜志, 2017, 37(8): 896-899.
19. 樓健穎, 陳偉, 王冀, 等. 一期擴張法經皮經肝膽道鏡在肝內外膽管結石治療中的應用(附 35 例報告). 中國實用外科雜志, 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, 張劍權, 符國珍, 等. 經皮肝穿刺膽管造瘺電子膽道鏡取石術治療肝內膽管結石的近遠期療效. 中華普通外科雜志, 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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