One-step percutaneous transhepatic cholangioscopic lithotripsy in patients with choledocholithiasis - 20/04/21
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Highlights |
• | ERCP may be inappropriate for some patients with choledocholithiasis. |
• | One-step PTCSL is beneficial in the treatment of patients with choledocholithiasis. |
• | One-step PTCSL might be a reasonable alternative in the treatment of choledocholithiasis patients, especially when ERCP is not feasible. |
Summary |
Background |
Endoscopic retrograde cholangiopancreatography (ERCP) may be inappropriate for most patients with choledocholithiasis. This study aimed to evaluate one-step percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) in the treatment of patients with choledocholithiasis who could not undergo ERCP (e.g., failed ERCP, altered anatomy, and/or contra-indications).
Method |
This was a retrospective single-centre series of 67 patients who underwent choledocholithiasis between November 2015 and March 2018: 35 with one-step PTCSL (Group A) and 32 with laparoscopic common bile duct (CBD) exploration (Group B).
Results |
Compared with Group B, Group A showed shorter duration of operation, length of stay in the hospital, postoperative hospital stay, postoperative drainage time, and time to oral intake (all P<0.05). Intraoperative blood loss, costs, conversion to open surgery (one in group A vs. seven in group B; P=0.023), and bile leakage (none in group A vs. four in group B; P=0.047) were lower in Group A than in Group B. There were no significant differences between the two groups regarding the intraoperative clearance rate, ultimate clearance rate, and several postoperative complications.
Conclusion |
One-step PTCSL could be an alternative for patients with choledocholithiasis, especially when ERCP is not feasible.
Le texte complet de cet article est disponible en PDF.Keywords : Percutaneous transhepatic cholangioscopic lithotripsy, Choledocholithiasis, Endoscopic retrograde cholangiopancreatography, Laparoscopic
Abbreviations : ERCP, CBD, BDS, PTBD, PTC, 3D, EHL, SD
Plan
Vol 45 - N° 2
Article 101477- mars 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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