Document Detail


Reappraisal of percutaneous transhepatic cholangioscopic lithotomy for primary hepatolithiasis.
MedLine Citation:
PMID:  15959714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A review of the literature pertaining to percutaneous transhepatic cholangioscopic lithotomy (PTCSL) showed that more than 50% of reported patients had undergone earlier biliary surgery. METHODS: A retrospective study investigated 74 patients undergoing initial PTCSL for hepatolithiasis who had undergone no prior biliary surgery or manipulation. The patients were followed for 1 to 23 years after PTCSL for effective evaluation of the procedure outcome. RESULTS: Complete clearance of hepatolithiasis was achieved for 61 (82%) patients. The incomplete clearance rate was higher for patients with intrahepatic duct stricture (11/37 [30%] vs 2/37 [5%]; p < 0.05), although it showed no relation to the actual lobar distribution of hepatolithiasis (left: 7/41 [17%] vs right: 2/11 [18%] vs bilateral: 4/22 [18%]; p < 0.05). The recurrence rate for hepatolithiasis also was higher for patients with intrahepatic duct stricture (18/26 [69%] vs 13/35 [37%]; p < 0.05), but the recurrence rate showed no relation to the lobar distribution of hepatolithiasis (left: 18/34 [53%] vs right: 4/9 [44%] vs bilateral: 9/18 [50%] p > 0.05) or the presence of gallbladder stones (5/12 [42%] vs 26/49 [53%]; p > 0.05). Patients showing the coexistence of retained or recurrent hepatolithiasis demonstrated a higher incidence of recurrent cholangitis (57% [13/23] vs 14% [7/51]; p < 0.01) or cholangiocarcinoma (17% [4/23]) vs 0% [0/51]; p < 0.01). CONCLUSIONS: The findings show that PTCSL is effective for treating primary hepatolithiasis, and that complete stone clearance is mandatory to diminish the sequelae of hepatolithiasis. Intrahepatic duct stricture was the main factor contributing to incomplete clearance and stone recurrence.
Authors:
C- H Chen; M- H Huang; J- C Yang; C- C Yang; Y- H Yeh; H- S Wu; D- A Chou; S- K Yueh; C- K Nien
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Publication Detail:
Type:  Journal Article     Date:  2005-02-03
Journal Detail:
Title:  Surgical endoscopy     Volume:  19     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-06-16     Completed Date:  2006-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  505-9     Citation Subset:  IM    
Affiliation:
Digestive Disease Center, Show-Chwan Memorial Hospital, 542, Section 1 Chung-Shang Road, Changhua 500, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cholangiocarcinoma / epidemiology
Cholangitis / epidemiology
Cholelithiasis / epidemiology
Comorbidity
Constriction, Pathologic / epidemiology
Female
Follow-Up Studies
Gallbladder Neoplasms / epidemiology
Hepatectomy
Hepatic Duct, Common / pathology
Humans
Laparoscopy / methods*
Lithiasis / surgery*
Lithotripsy
Liver Abscess / epidemiology
Liver Diseases / surgery*
Male
Middle Aged
Postoperative Complications / epidemiology
Recurrence
Reoperation
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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