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One-Step Multichannel Percutaneous Transhepatic Cholangioscopic Lithotripsy Applied in Bilateral Hepatolithiasis

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Abstract

Background

The aim of this study was to compare the outcomes of one-step multichannel percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) with traditional PTCSL in the treatment of bilateral hepatolithiasis.

Methods

From February 2011 to June 2015, 156 patients with bilateral hepatolithiasis received surgical treatment in our department. Among these patients, 81 received one-step multichannel PTCSL (group A), and the remaining 75 received traditional PTCSL (group B).

Results

Compared with group B, group A was characterized by a significantly shorter operation time (83.7 ± 28.5 min vs 118.1 ± 41.5 min; P = 0.000), hospital stay (11.1 ± 3.4 d vs 17.8 ± 5.6 d; P = 0.034), and postoperative hospital stay (6.9 ± 3.1 d vs 9.6 ± 4.5 d; P = 0.026). In addition, the immediate clearance (62.9% vs 45.3%, P = 0.027) and final clearance (90.1% vs 78.7%, P = 0.048) rates were higher in group A than in group B. During the follow-up period, stone recurrence was significantly less common in group A than in group B (13.6% vs 26.7%, P = 0.041). Multivariate Cox analysis showed that the PTCSL method (HR = 2.32, 95% confidence interval [CI] = 1.09–4.90, P = 0.028), bilateral biliary stricture (HR = 4.17, 95% CI = 1.73–10.03, P = 0.001), and stones located in segments I (HR = 7.75, 95% CI = 3.67–16.38, P = 0.000) were independent predictors of recurrence.

Conclusions

Compared with traditional PTCSL, one-step multichannel PTCSL was more efficient and effective in the treatment of bilateral hepatolithiasis.

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Funding

The Medical Scientific Research Foundation of Guangdong Province (Grant No. A2013254); The Guangdong Science and Technology Program (Grant No. 2017ZC0222); and The Guangzhou Minsheng Science and Technology Research Program (Grant No. 201803010065).

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Author notes

  1. Haisu Tao and Ping Wang have contributed equally to this work.

Authors and Affiliations

  1. Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China

    Haisu Tao

  2. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510282, Guangdong Province, China

    Ping Wang, Beiwang Sun, Kun Li & Canhua Zhu

Authors
  1. Haisu Tao
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  2. Ping Wang
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  3. Beiwang Sun
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  4. Kun Li
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  5. Canhua Zhu
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Contributions

HT was involved in study conception and design; HT, PW, BS, and KL were involved in acquisition of data; HT, PW, and CZ were involved in analysis and interpretation of data; and HT and PW were involved in drafting of manuscript.

Corresponding author

Correspondence to Ping Wang.

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Informed consent was obtained from all individual participants included in the study.

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Tao, H., Wang, P., Sun, B. et al. One-Step Multichannel Percutaneous Transhepatic Cholangioscopic Lithotripsy Applied in Bilateral Hepatolithiasis. World J Surg 44, 1586–1594 (2020). https://doi.org/10.1007/s00268-020-05368-7

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  • DOI: https://doi.org/10.1007/s00268-020-05368-7

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