Korean J Gastroenterol.  2000 Mar;35(3):356-366.

Treatment of Hepatolithiasis by Percutaneous Transhepatic Cholangioscopy: Immediate and Long-term Results

• Park ET
• Lee SK
• Kim MH
• Myung SJ
• Seo DW
• Kim HJ
• Lim BC
• Yoo KS
• Yoon HK
• Sung KB
• Seol SY
• Min YI

Abstract

The immediate and long-term results of percutaneous transhepatic cholangioscopic lithotomy for the intrahepatic stones were analyzed according to degree of biliary stricture, severity of cirrhosis, and Tsunoda classification.
METHODS
We studied retrospectively medical records of 92 patients with hepatolithiasis who received percutaneous transhepatic cholangioscopy (PTCS) treatment from September 1992 to May 1997. Sixty-eight patients were followed up for 24 to 60 months (median 42 months).
RESULTS
Complete clearance of the intrahepatic stones was achieved in 74 patients (80%). In group A (Tsunoda class I and II), no recurrence was observed upto 28 months of follow-up. However, in the patients of group B (Tsunoda class III and IV), recurrence rates were increased continuously, and 50% of them had eventually recurrence of stones or cholangitis.
CONCLUSIONS
PTCS is an effective and safe procedure for management of hepatolithiasis in patients who are not candidates for surgical resection. In cases of severe and multiple strictures, adequate dilatation of bile duct strictures and close follow-up are necessary.

Keyword

Intrahepatic stones; Percutaneous transhepatic cholangioscopy; Tsunoda classification

MeSH Terms

Bile Ducts
Cholangitis
Classification
Constriction, Pathologic
Dilatation
Fibrosis
Follow-Up Studies
Humans
Medical Records
Recurrence
Retrospective Studies