Percutaneous transhepatic one-step biliary fistulation for patients with hepatolithiasis and hepatobiliary surgery history

Objective To observe the clinical effect of percutaneous transhepatic one-step biliary fistulation (PTOBF) and percutaneous transhepatic cholangioscopy (PTCS) in the treatment of hepatolithiasis with hepatobiliary surgery history, and to explore the clinical application value of PTOBF. Methods This is retrospective analysis of 68 patients with hepatolithiasis who were admitted to hepatobiliary surgery in the First Affiliated Hospital of Guangzhou Medical University from November 2009 to October 2017. Among these cases, 35 patients in the observation group (group PTOBF) were treated with PTOBF, and 33 patients in the control group (group PTCS) received PTCS treatment. The final clearance rate, the postoperative complications rate, the hospitalization time, the operation times within the course of treatment, the recurrence rate and the residual stenosis rate of the two groups were compared. Results Compared with group PTCS, the clearance rate was significantly higher in group PTOBF(82.9% vs 54.6%, P 0.05); Besides, the hospitalization time(12.3±5.3 d vs 17.4±7.0 d, P<0.05), the operation times within the course of treatment(2.2±1.3 vs 2.8±1.0, P<0.05) and the recurrence rate(17.4% vs 39.4%, P<0.05) of group PTOBF were obviously lower. Conclusions PTOBF is a safe and feasible treatment for hepatolithiasis with hepatobiliary surgery history. Compared with PTCS, it has the advantages of short hospitalization time, fewer operations and better recovery. Key words: Cholelithiasis; Biliary tract surgical procedures; Biliary fistulation; Cholangioscopy; Hepatolithiasis