Percutaneous Transhepatic Cholangioscopy and Lithotripsy of Intrahepatic Stones

Madeira-Cardoso, Maria João; Almeida, Nuno; Correia, Catarina; Duque, Mariana Perez; Agostinho, Alfredo Gil; Alexandrino, Henrique

doi:10.1159/000511529

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…7 PTCS is also a minimally invasive promising option and is used to treat intrahepatic stones by expanding the PTCS access gradually. 13 However, risk of bleeding, biliary fistula or infection is potentially increased in patients with a compromised biliary tract by previous infections. 14 In these cases, hepatectomy shows the most favourable outcome, as it removes all causative lesions with lower recurrence rate, also reducing the risk of developing cholangiocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic lithiasis managed with hepatectomy and anterograde cholangioscopy through the right posterior sectorial duct

Matos,

Ferreira,

Alexandrino

et al. 2024

Int Surg J

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Intrahepatic lithiasis, endemic in East Asia, is increasing in Western countries and without proper treatment, may cause cholangitis, liver abscesses, biliary cirrhosis, and cholangiocarcinoma. Management may require endoscopic, percutaneous, or surgical approach to the bile duct. Anterograde approach through the stump of the biliary duct during hepatectomy has been reported only rarely. We present a case managed through an anterograde approach, which is a valid alternative that preserves the integrity of the main biliary tree. A 76-year-old woman presented with recurrent severe cholangitis episodes and intrahepatic lithiasis in the right posterior sectorial bile duct, with a dominant stone in the junction with the left duct. Due to a variation in the biliary tree anatomy, the retrograde access was difficult and after undergoing several unsuccessful attempts at endoscopic clearance, she was offered surgical therapy. Right posterior sectionectomy and common bile duct anterograde exploration through the stump were performed, for stones clearance. The anterograde approach allowed complete hepaticolitothomy, preserving the main biliary tree and preventing anastomotic stricture or leakage. This technique should be considered in sectorial limited intrahepatic lithiasis with steep angle of drainage, unapproachable by retrograde access.

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Section: Discussionmentioning

confidence: 99%

Intrahepatic lithiasis managed with hepatectomy and anterograde cholangioscopy through the right posterior sectorial duct

Matos,

Ferreira,

Alexandrino

et al. 2024

Int Surg J

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“…Антеградная холангиоскопия также может быть использована в лечебных целях -при множественных и крупных конкрементах ЖП при невозможности стандартной ретроградной литэкстракции и литотрипсии [10]. Для литэкстракции применяют несколько методов, в том числе стандартное удаление конкрементов с помощью корзинки Дормиа, а при необходимости -электрогидравлическую ударно-волновую и лазерную литотрипсию [11,12]. При проксимальных послеоперационных руб-цовых стриктурах антеградная холангиоскопия имеет преимущества по сравнению с традиционным наружновнутренним дренированием.…”

Section: вве де ниеunclassified

Diagnostic and therapeutic cholangioscopy performed by various accesses to the bile ducts

Nedoluzhko,

Kulezneva,

Grishina

et al. 2024

Ann. hir. gepatol.

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Aim. To summarize data, define indications and estimate outcomes of cholangioscopy performed by various accesses to the bile ducts. Materials and methods. In the period of 2017–2024, 68 cholangioscopies were performed in 24 (35.3 %) men and 44 (64.7 %) women. The age of patients ranged from 18 to 85 years (mean age comprises 61 years). 10 (14.7 %) cholangioscopies were performed by retrograde access, 42 (61.8 %) by antegrade access, and 16 (23.5 %) were performed intraoperatively. Results. The total amount of interventions include 21 (30.9 %) lithoextractions, 16 (23.5 %) targeted biopsies, 12 (17.6 %) recanalizations of anastomosis strictures, and 1 (1.79 %) case involved a retrieval of the “lost” bile duct stent. In 7 (10.3 %) cases cholangioscopy failed due to a small diameter of the bile ducts. Conclusion. Contemporary minimally invasive endoscopic methods considerably enlarge the possibilities for treatment of complex lesions of the bile ducts. Antegrade cholangioscopy contributes to a wider application of modern technologies for direct examination of the bile ducts and to expansion of the range of therapeutic manipulations. The introduction of antegrade cholangioscopy avoids extensive traumatic reconstructive interventions with their potential risk of complications.

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“…Regarding the management of postoperative drainage tubes, the presence of an indwelling drainage tube serves multiple purposes, such as helping to prevent the occurrence of cholangitis and enabling timely monitoring and irrigation in mitigating complications such as bleeding, infection, catheter displacement, and dislocation. Additionally, if necessary, the drainage condition can be assessed through cholangiography ( 75 ).…”

Section: Complications Of Ptcsmentioning

confidence: 99%

Percutaneous transhepatic choledochoscopy in the management of hepatolithiasis: a narrative review

Wang,

2024

Quant Imaging Med Surg

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Background and Objective From the 1980s and continuing into the 21st century, percutaneous transhepatic choledoscopy (PTCS) has been increasingly used in the clinical management of cholelithiasis. However, when compared to conventional minimally invasive techniques such as endoscopic retrograde cholangiopancreatography (ERCP), PTCS is characterized by greater invasiveness and a higher rate of complications. As a result, PTCS is frequently used as a supplementary treatment option. Nevertheless, it plays a unique and indispensable role in addressing hepatolithiasis. In this study, to facilitate safer clinical applications and gain a deeper understanding of PTCS-related complications, we conducted a comprehensive examination of these complications. Methods Research studies related to PTCS were reviewed in PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) (year range, 1952–2024). There was no restriction on language. The occurrence and management of complications at various steps of PTCS were examined and compared with those of first-line minimally invasive treatments via a tabular method. Additionally, we evaluated the feasibility of using PTCS in the context of intrahepatic bile duct stones. Key Content and Findings Information on the types, incidence, and treatment of complications of PTCS was extracted in this review. A total of 5,923 results were retrieved, of which 41 were excluded. The reason for exclusion was that the article was a meeting comment. The findings indicate that PTCS plays an important role in the treatment of biliary tract diseases. Conclusions Although PTCS is frequently used as an adjunctive therapeutic approach, its distinct utility in treating intrahepatic bile duct stones remains difficult to replace. Thus, a deeper understanding of PTCS-related complications, coupled with ongoing advancements in instrumentation, could significantly enhance the efficiency of minimally invasive gallstone management.

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Percutaneous Transhepatic Cholangioscopy and Lithotripsy of Intrahepatic Stones

Cited by 5 publications

References 5 publications

Intrahepatic lithiasis managed with hepatectomy and anterograde cholangioscopy through the right posterior sectorial duct

Intrahepatic lithiasis managed with hepatectomy and anterograde cholangioscopy through the right posterior sectorial duct

Diagnostic and therapeutic cholangioscopy performed by various accesses to the bile ducts

Percutaneous transhepatic choledochoscopy in the management of hepatolithiasis: a narrative review

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