Application of real-time virtual sonography combined with intraductal biliary contrast-enhanced ultrasound in percutaneous transhepatic cholangial drainage
10.3760/cma.j.cn112139-20241228-00596
- VernacularTitle:实时超声影像融合联合经胆管腔内超声造影在经皮肝胆管穿刺置管引流术中的应用
- Author:
Huajun WU
1
;
Jianwei YI
1
;
Zhigang HU
1
;
Binghai ZHOU
1
;
Jiafu GUAN
1
;
Jinlong YAN
1
;
Xin YU
1
;
Rongfa YUAN
1
;
Shubing ZOU
1
;
Kai WANG
1
Author Information
1. 南昌大学第二附属医院肝胆胰外科，南昌330006
- Publication Type:Journal Article
- Keywords:
Bile duct diseases;
Percutaneous transhepatic cholangial drainage;
Real-time virtual sonography;
Intra-biliary contrast enhanced ultrasound
- From:
Chinese Journal of Surgery
2025;63(8):732-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of real-time virtual sonography (RVS) combined with intraductal biliary contrast-enhanced ultrasound (IB-CEUS) in percutaneous transhepatic cholangial drainage (PTCD).Methods:This retrospective cohort study included data from 71 patients who underwent PTCD at the Department of Hepatobiliary and Pancreatic Surgery in the Second Affiliated Hospital of Nanchang University between May 2021 and August 2022. There were 36 male and 35 female patients,aged 35 to 94 years. Based on the guidance modality used,patients were divided into two groups: the RVS combined with IB-CEUS group ( n=36) and the digital subtraction angiography (DSA) group ( n=35). PTCD was performed under the guidance of RVS combined with IB-CEUS in the RVS+IB-CEUS group,and under conventional DSA fluoroscopic guidance in the DSA group. Two clinicians classified the biliary conditions as either simple or complex based on preoperative ultrasound and CT (or MRI) imaging. Statistical analyses were conducted using independent sample t-tests,rank-sum tests, χ2 tests,or Fisher′s exact tests,as appropriate. Results:Significant differences were observed between the RVS+IB-CEUS group and the DSA group in terms of the number of punctures (1.0±0.2 vs. 2.2±1.4, t=-5.148, P<0.01) and postoperative complication rate(2.8% (1/35) vs. 17.1% (6/36), P=0.049). There were 9 patients with complex biliary conditions in the DSA group and 12 in the RVS+IB-CEUS group. The number of punctures in both the simple and complex subgroups of the RVS+IB-CEUS group(1.0±0.2 and 1.0±0.0) remained lower than that in the corresponding DSA subgroups(2.2±1.6 and 2.4±0.4) ( t=-3.606, P<0.01; t=-3.959, P=0.002). Moreover,the complication rate in the simple biliary subgroup of the RVS+IB-CEUS group was significantly lower than that of the DSA group(0 (0/24) vs. 19.2% (5/26), P=0.031),whereas no significant difference was found in the complex biliary subgroup (1/12 vs. 1/9, P=0.686). Conclusion:Guided by RVS and IB-CEUS, PTCD can help reduce the number of punctures during surgery and postoperative complications, and patients with complex bile duct conditions can still benefit from PTCD.
