Jan Y Y, Chen M F
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung College of Medicine & Technology, Taipei, Taiwan, Republic of China.
Gastrointest Endosc. 1995 Jul;42(1):1-5. doi: 10.1016/s0016-5107(95)70234-2.
A prospective study was undertaken to evaluate the long-term results of percutaneous trans-hepatic cholangioscopic lithotomy in 48 patients with hepatolithiasis during a 4- to 10-year follow-up period. Complete clearance of the intrahepatic stones was achieved in 40 patients (83.3%). In these 40 patients, long-term results during the follow-up period were as follows: free of symptoms and without evidence of recurrent stones, 22 patients (55%); free of symptoms with recurrent stones, 2 patients; recurrent stones with cholangitis, 14 patients (35%); symptoms of cholangitis without evidence of recurrent stones, 2 patients. Of those patients with recurrent stones, secondary biliary cirrhosis developed in 1, and in 9 of the patients in whom secondary cholangitis developed, subsequent laparotomy or percutaneous drainage was required. Three of the 40 patients (7.5%) died within the 4- to 10-year follow-up period. The procedural failure rate in terms of stone retention was 20.5% for patients with bile duct strictures. No stones were retained in patients without strictures. The postprocedural rate of stone recurrence for patients with bile duct strictures was 51.6%; no recurrence was seen in patients without strictures.
一项前瞻性研究对48例肝内胆管结石患者进行了经皮经肝胆道镜取石术，并进行了4至10年的随访，以评估其长期疗效。40例患者（83.3%）实现了肝内结石的完全清除。在这40例患者中，随访期间的长期疗效如下：无症状且无结石复发迹象，22例患者（55%）；无症状但有结石复发，2例患者；结石复发伴胆管炎，14例患者（35%）；有胆管炎症状但无结石复发迹象，2例患者。在结石复发的患者中，1例发生了继发性胆汁性肝硬化，在发生继发性胆管炎的9例患者中，随后需要进行剖腹手术或经皮引流。40例患者中有3例（7.5%）在4至10年的随访期内死亡。胆管狭窄患者结石残留的手术失败率为20.5%。无狭窄患者无结石残留。胆管狭窄患者术后结石复发率为51.6%；无狭窄患者未见复发。
