Value of ERCP in the treatment of hepatolithiasis
10.3760/cma.j.cn113884-20250306-00080
- VernacularTitle:ERCP在肝内胆管结石治疗中的价值
- Author:
Xin DENG
1
;
Tong MOU
1
;
Qiao WU
1
Author Information
1. 重庆医科大学附属第一医院肝胆外科，重庆 400016
- Publication Type:Journal Article
- Keywords:
Gallstones;
Endoscopic retrograde cholangiopancreatography;
Hepatolithiasis;
Peroral cholangioscopy
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(6):410-414
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the value of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of hepatolithiasis.Methods:Clinical data of 59 patients with hepatolithiasis undergoing ERCP combined with peroral cholangioscopy (POCS) between January 2021 and December 2022 at the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed, including 18 males and 41 females, aged 68(57, 76) years. The demographic and perioperative data of patients were systematically documented, including gender, age, operative time, length of hospitalization (LOH), stone clearance rate, and procedure-related complications. Comparative analysis of white blood cell (WBC) count and serum albumin (ALB) were performed between baseline (pre-lithotripsy) and one day postoperatively.Results:All 59 patients underwent combined ERCP-POCS procedure successfully without perioperative mortality. The LOH was 5 (4, 6) d, with an operative time of (82.7±27.7) min. The number of ERCP sessions required was 2 (2, 3), accompanied by stone fragmentation procedure 1 (1, 2). POCS were able to be inserted in all 59 patients to observe the trunk of second- and third-order intrahepatic bile ducts, with a technical success rate of 100%(59/59). Complete stone clearance was observed in 88.1% (52/59) of patients. Comparative analysis of pre- and post-operative biochemical profiles revealed significant alterations: ALB decreased from (39.78±4.22) g/L to (35.76±3.66) g/L ( P<0.05), WBC count increased from 5.63(3.96, 8.65)×10 9/L to 8.55(5.83, 11.46)×10 9/L ( P<0.05). The incidence of procedure-related complications was 11.9% (7/59). The follow-up period for the patients was 10 (7, 16) months. Stones recurred in four of the 52 patients with complete stone removal. The seven patients without complete stone removal did not experience any significant discomfort during follow-ups, and residual stones were not treated again. Conclusion:ERCP combined with POCS is safe and effective for the treatment of hepatolithiasis.
