Ultrasound-guided percutaneous transhepatic one-step biliary fistulation combined with rigid choledochoscopy for recurrent hepatolithiasis

Abstract

Abstract (1) Purpose: Percutaneous transhepatic one-step biliary fistulation (PTOBF) is used to treat choledocholithiasis and biliary stricture. This study aimed to evaluate the safety and efficacy of ultrasound-guided PTOBF combined with rigid choledochoscopy in the treatment of recurrent hepatolithiasis. (2) Materials and Methods: The clinical data of 37 consecutive patients who underwent PTOBF combined with rigid choledochoscopy for RHL from March 2020 to March 2022 at our hospital were retrospectively analyzed. (3) Results: A total of 68 percutaneous transhepatic punctures were performed in 37 patients, with a puncture success rate of 85.29% (58/68) and a dilatation success rate of 100.00% (58/58). The mean blood loss of operation was 9.84±18.10mL, the mean operation time was 82.05±31.92min, and the mean length of postoperative hospital stay was 5.59±3.26 days. The initial stone clearance rate was 40.54% (15/37) and the final stone clearance rate was 100% (37/37). The incidence of postoperative complications was 10.81% (4/37), including 2 cases of pleural effusion, 1 case of hemorrhage, and 1 case of cholangitis, which recovered after treatment. During a mean follow-up period of 23 months (range 12 to 36 months), only 1 patient experienced stone recurrence. (4) Conclusion: Ultrasound-guided PTOBF combined with rigid choledochoscopy is safe, effective, and minimally invasive for the treatment of RHL, and has clinical application value.