Percutaneous transhepatic Laser lithotripsy for intrahepatic cholelithiasis - 26/11/19
Abstract |
Purpose |
To report the technical success, complications and long-term outcomes of patients with intrahepatic cholelithiasis not amenable to endoscopic retrograde cholangiopancreatography (ERCP) who were treated with percutaneous transhepatic biliary Laser lithotripsy (PTBLL).
Patients and methods |
A retrospective review of 12 patients who underwent PTBLL for intrahepatic cholelithiasis was performed. There were 5 men and 7 women with a mean age of 46±18 (SD) years (range: 23–75 years). PTBLL was performed when stone clearance using ERCP had previously failed or was not appropriate due to unfavourable anatomy or the presence of multiple stones or a large stone. Percutaneous biliary access into intrahepatic ducts was obtained if not already present and lithotripsy was performed using a HolmiumYAG 2100nM Laser. Patients files were analyzed to determine the technical success, complications and long-term outcomes.
Results |
Eleven patients (11/12; 92%) had a history of previous hepatobiliary surgery and nine (9/12; 75%) had multiple stones confirmed on preprocedure imaging. A 100% success rate in fragmenting the target stone(s) was achieved and 11/12 patients (92%) had successful first pass extraction of target stone fragments. Two patients (2/12; 17%) required repeat lithotripsy. One patient (1/12; 8%) experienced a major complication in the form of cholangitis. Of patients with long-term follow-up, 4/10 (40%) had recurrence of intrahepatic calculi with a mean time interval of 31 months (range 3–84 months).
Conclusion |
For patients with intrahepatic biliary calculi not amenable to ERCP, PTBLL provides an effective and safe alternate treatment.
El texto completo de este artículo está disponible en PDF.Keywords : Hepatolithiasis, Biliary calculi, Percutaneous transhepatic biliary lithotripsy, Holmium Laser
Esquema
Vol 100 - N° 12
P. 793-800 - décembre 2019 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.