Re-operation of percutaneous transhepatic one-step biliary fistulation and percutaneous transhepatic choledochoscope lithotomy in treatment of patients with recurrent hepatolithiasis after Roux-en-Y cholangiojejunostomy
Objective The aim of this study was to investigate re-operation of percutaneous transhepatic one-step biliary fistulation(PTOBF)and percutaneous transhepatic choledochoscope lithotomy(PTCSL)in treatment of patients with recurrent hepatolithiasis after Roux-en-Y cholangiojejunostomy.Methods 83 patients with relapsed hepatolithiasis after Roux-en-Y cholangiojejunostomy were enrolled in our hospital between January 2020 and December 2022,and 31 cases in control group received PTCSL and 52 cases in observation group underwent PTOBF and PTCSL combination surgery.All patients in the two groups were followed-up by ultrasonography check-up.Results The operation time and post-operational hospital stay in the observation group were(136.3±29.5)min and 6.1(4.7,7.8)d,much longer than[(63.9±7.7)min and 4.1(3.9,5.2)d,respectively,P＜0.05]in the control;the success rates of one-time puncture and one-time fistula dilation in the observation group were 76.9%and 94.2%,much higher than 54.8%and 67.7%(P＜0.05)in the control;there were no significant differences as respect to liver function tests in the two groups before and after operation(P＞0.05);post-operationally,the shedding incidence of drainage tubes in the observation was 1.9%,much lower than 25.8%(P＜0.05)in the control,while there were no significant differences respect to the incidences of biliary bleeding and pleural effusion(1.9%vs.3.2%and3.9%vs.3.2%,respectively,P＞0.05)between the two groups;the post-operational follow-up showed the re-occurrence of intrahepatic stones in the observation was 3.9%,much lower than 16.1%(P＜0.05)in the control group.Conclusion The application of PTOBF and PTCSL combination in dealing with patients with recurrent hepatolithiasis after Roux-en-Y cholangiojejunostomy is efficacious,with a good success rates of one-time puncture and one-time fistula dilation,and relatively low stone recurrence rates.
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