Three-dimensional visualization technology for guiding one-step percutaneous transhepatic cholangioscopic lithotripsy for the treatment of complex hepatolithiasis  

作　　者：Yong-Qing Ye Ya-Wen Cao Rong-Qi Li En-Ze Li Lei Yan Zhao-Wei Ding Jin-Ming Fan Ping Wang Yi-Xiang Wu 

机构地区：[1]Department of Hepatobiliary Surgery,The Second People’s Hospital of Foshan,Foshan 528000,Guangdong Province,China [2]Department of Emergency Medicine,Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,Guangdong Province,China [3]Department of Hepatobiliary Surgery,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong Province,China [4]Department of Hepatobiliary Surgery,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510282,Guangdong Province,China [5]Department of Gastrointestinal Surgery,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,Guangdong Province,China

出　　处：《World Journal of Gastroenterology》2024年第28期3393-3402,共10页世界胃肠病学杂志（英文版）

基　　金：Supported by The Key Medical Specialty Nurturing Program of Foshan During The 14th Five-Year Plan Period,No.FSPY145205;The Medical Research Project of Foshan Health Bureau,No.20230814A010024;The Guangzhou Science and Technology Plan Project,No.202102010251;the Guangdong Science and Technology Program,No.2017ZC0222.

摘　　要：BACKGROUND Biliary stone disease is a highly prevalent condition and a leading cause of hospitalization worldwide.Hepatolithiasis with associated strictures has high residual and recurrence rates after traditional multisession percutaneous transhepatic cholangioscopic lithotripsy(PTCSL).AIM To study one-step PTCSL using the percutaneous transhepatic one-step biliary fistulation(PTOBF)technique guided by three-dimensional(3D)visualization.METHODS This was a retrospective,single-center study analyzing,140 patients who,between October 2016 and October 2023,underwent one-step PTCSL for hepatolithiasis.The patients were divided into two groups:The 3D-PTOBF group and the PTOBF group.Stone clearance on choledochoscopy,complications,and long-term clearance and recurrence rates were assessed.RESULTS Age,total bilirubin,direct bilirubin,Child-Pugh class,and stone location were similar between the 2 groups,but there was a significant difference in bile duct strictures,with biliary strictures more common in the 3D-PTOBF group(P=0.001).The median follow-up time was 55.0(55.0,512.0)days.The immediate stone clearance ratio(88.6%vs 27.1%,P=0.000)and stricture resolution ratio(97.1%vs 78.6%,P=0.001)in the 3D-PTOBF group were significantly greater than those in the PTOBF group.Postoperative complication(8.6%vs 41.4%,P=0.000)and stone recurrence rates(7.1%vs 38.6%,P=0.000)were significantly lower in the 3D-PTOBF group.CONCLUSION Three-dimensional visualization helps make one-step PTCSL a safe,effective,and promising treatment for patients with complicated primary hepatolithiasis.The perioperative and long-term outcomes are satisfactory for patients with complicated primary hepatolithiasis.This minimally invasive method has the potential to be used as a substitute for hepatobiliary surgery.

关 键 词：HEPATOLITHIASIS One-step percutaneous transhepatic cholangioscopic lithotripsy Biliary disease Three-dimensional visualization Clinical efficacy 

分 类 号：R575[医药卫生—消化系统]