TY - JOUR
T1 - Are modified procedures significantly better than conventional procedures in percutaneous transhepatic treatment for complicated right hepatolithiasis with intrahepatic biliary strictures?
AU - Jeng, K. S.
AU - Sheen, I. Shyan
AU - Yang, F. S.
PY - 2002
Y1 - 2002
N2 - Background: Conventional percutaneous procedures for treating patients with recurrent hepatolithiasis associated with complicated intrahepatic biliary strictures require multiple dilation sessions before stone extraction. We modified the approach, reducing the number of dilation sessions required and using newer lithotripsy and irrigation methods. We suggest that the modified procedures are superior to conventional management and demonstrate their utility in clearing hepatolithiasis. Methods: Percutaneous transhepatic stricture dilation and cholangioscopic lithotripsy were performed to treat patients with right recurrent hepatolithiasis with complicated intrahepatic biliary strictures. Conventional methods were used in 40 patients (Group A). Modified methods, including simplification of tract establishment and stricture dilation and electrohydraulic lithotripsy (EHL) were used in 60 patients (Group B). Results: Group B patients had fewer complications (massive hemobilia: 0% versus 15%, P = 0.0032; cholangitis: 0% versus 17.5%, P = 0.0012), tolerated the procedures better (intolerable pain: 0% versus 12.5%, P = 0.0087), had a higher rate of success (residual stones: 3.3% versus 20%, P = 0.0132; remaining asymptomatic and stone-free: 81% versus 50%, P = 0.0021), a shorter hospital stay (17.8 ± 4.4 days versus 36.2 ± 5.5 days, P < 0.001) and lower overall expense (USD 2689 versus USD 3848) than Group A patients. Conclusion: We believe that the modified methods are superior to conventional treatment in that they effectively decrease procedural complications and cost, and significantly improve treatment results.
AB - Background: Conventional percutaneous procedures for treating patients with recurrent hepatolithiasis associated with complicated intrahepatic biliary strictures require multiple dilation sessions before stone extraction. We modified the approach, reducing the number of dilation sessions required and using newer lithotripsy and irrigation methods. We suggest that the modified procedures are superior to conventional management and demonstrate their utility in clearing hepatolithiasis. Methods: Percutaneous transhepatic stricture dilation and cholangioscopic lithotripsy were performed to treat patients with right recurrent hepatolithiasis with complicated intrahepatic biliary strictures. Conventional methods were used in 40 patients (Group A). Modified methods, including simplification of tract establishment and stricture dilation and electrohydraulic lithotripsy (EHL) were used in 60 patients (Group B). Results: Group B patients had fewer complications (massive hemobilia: 0% versus 15%, P = 0.0032; cholangitis: 0% versus 17.5%, P = 0.0012), tolerated the procedures better (intolerable pain: 0% versus 12.5%, P = 0.0087), had a higher rate of success (residual stones: 3.3% versus 20%, P = 0.0132; remaining asymptomatic and stone-free: 81% versus 50%, P = 0.0021), a shorter hospital stay (17.8 ± 4.4 days versus 36.2 ± 5.5 days, P < 0.001) and lower overall expense (USD 2689 versus USD 3848) than Group A patients. Conclusion: We believe that the modified methods are superior to conventional treatment in that they effectively decrease procedural complications and cost, and significantly improve treatment results.
KW - Electrohydraulic lithotripsy
KW - Hepatolithiasis
KW - Intrahepatic biliary strictures
KW - Percutaneous transhepatic cholangioscopic lithotripsy
KW - Percutaneous transhepatic stricture dilation
UR - http://www.scopus.com/inward/record.url?scp=0036000215&partnerID=8YFLogxK
U2 - 10.1080/00365520252903161
DO - 10.1080/00365520252903161
M3 - 文章
C2 - 12059063
AN - SCOPUS:0036000215
SN - 0036-5521
VL - 37
SP - 597
EP - 601
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 5
ER -