Radiology Unit, Department of Diagnostic and Preventive Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Radiology Unit, Department of Diagnostic and Preventive Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy.
HPB (Oxford). 2019 Aug;21(8):1057-1063. doi: 10.1016/j.hpb.2018.12.007. Epub 2019 Feb 6.
The percutaneous approach (PA) for management of biliary stones (BS) with or without an underlying biliary stenosis is an option for patients in whom an endoscopic approach (EA) is not possible. The aim of this study was to evaluate the efficacy of a PA in patients with BS unsuitable for an EA.
A retrospective review of a database was performed. Inclusion criteria included patients with benign disease, BS who had undergone a PA. The outcomes were technical success rate, short (≤90 days) and long-term (>90 days) efficacy and safety.
A total of 91 patients enrolled were divided into those with (n = 38) or without (n = 53) a biliary stenosis. A median of 5 (IQR:3-7) treatments/patient were performed. During a median follow-up of 23 months (IQR:3-52), the median time free from recurrence was 21 months (CI:14-29). In the long term, the PA was most efficacious in those patients without a biliary stenosis with long term success in 68% of patients as compared to 36% of patients with a biliary stenosis (p = 0.003).
A PA is an effective procedure with high initial success rate, however the coexistence of stenosis affects long-term efficacy, especially in patients with chronic biliary disease.
经皮途径（PA）适用于无法进行内镜治疗（EA）的患者，用于治疗胆管结石（BS）合并或不合并胆管狭窄。本研究旨在评估经皮途径（PA）在不适合进行 EA 的 BS 患者中的疗效。
对数据库进行回顾性分析。纳入标准包括良性疾病患者，接受过 PA 治疗的 BS 患者。结局指标包括技术成功率、短期（≤90 天）和长期（>90 天）疗效和安全性。
共纳入 91 例患者，分为伴有（n=38）或不伴有（n=53）胆管狭窄的患者。中位治疗次数为 5（IQR：3-7）/患者。中位随访 23 个月（IQR：3-52）期间，无复发生存时间的中位数为 21 个月（CI：14-29）。长期来看，无胆管狭窄的患者的 PA 效果最佳，长期成功率为 68%，而伴有胆管狭窄的患者仅为 36%（p=0.003）。
PA 是一种有效的治疗方法，初始成功率高，但狭窄的存在会影响长期疗效，尤其是在患有慢性胆道疾病的患者中。
