Modified percutaneous transhepatic papillary balloon dilation for patients with refractory hepatolithiasis

Some patients with hepatolithiasis cannot tolerate surgery due to severe cardiac or pulmonary comorbidities, or cannot be endoscopically treated because of altered gastrointestinal anatomies. To propose a modified percutaneous transhepatic papillary balloon dilation procedure, and evaluate the clini...

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Published inWorld journal of gastroenterology : WJG Vol. 26; no. 27; pp. 3929 - 3937
Main Authors Liu, Bin, Cao, Pi-Kun, Wang, Yong-Zheng, Wang, Wu-Jie, Tian, Shi-Lin, Hertzanu, Yancu, Li, Yu-Liang
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 21.07.2020
Subjects
Catheterization - adverse effects
Common Bile Duct
Dilatation
Endoscopy
Female
Humans
Lithiasis - therapy
Liver Diseases - therapy
Male
Retrospective Studies
Retrospective Study
Treatment Outcome
Dilation
Common bile duct
Balloon
Percutaneous
Sphincter of Oddi
Intrahepatic cholestasis
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Summary:Some patients with hepatolithiasis cannot tolerate surgery due to severe cardiac or pulmonary comorbidities, or cannot be endoscopically treated because of altered gastrointestinal anatomies. To propose a modified percutaneous transhepatic papillary balloon dilation procedure, and evaluate the clinical efficacy and safety of this modality. Data from 21 consecutive patients who underwent modified percutaneous transhepatic papillary balloon dilation with hepatolithiasis were retrospectively analyzed. Using auxiliary devices, intrahepatic bile duct stones were pushed into the common bile duct and expelled into the duodenum with an inflated balloon catheter. The outcomes recorded included success rate, procedure time, hospital stay, causes of failure, and procedure-related complications. Patients with possible long-term complications were followed up for 2 years. Intrahepatic bile duct stones were successfully removed in 20 (95.23%) patients. Mean procedure time was 65.8 ± 5.3 min. Mean hospital stay was 10.7 ± 1.5 d. No pancreatitis, gastrointestinal, or biliary duct perforation was observed. All patients were followed up for 2 years, and there was no evidence of reflux cholangitis or calculi recurrence. Modified percutaneous transhepatic papillary balloon dilation was feasible and safe with a small number of patients with hepatolithiasis, and may be a treatment option in patients with severe comorbidities or in patients in whom endoscopic procedure was not successful.
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Supported by Natural Science Foundation of Shandong Province, No. ZR2018PH032 and No. ZR2018PH033; and National Natural Science Foundation of China, No. 61671276 and No. 11971269.
Author contributions: Liu B contributed to the study concept and design, analysis and interpretation of the data, drafting of the manuscript, and statistical analysis, and obtained funding; Cao PK contributed to the acquisition of data, analysis and interpretation of data, and statistical analysis; Wang YZ contributed to the technical support and critical revision of the manuscript for important intellectual content; Wang WJ contributed to the technical support and statistical analysis; Tian SL contributed to the acquisition of data and material support; Hertzanu Y contributed to the critical revision of the manuscript for important intellectual content; Li YL contributed to the study concept and design, study supervision, critical revision of the manuscript for important intellectual content, and obtained funding.
Corresponding author: Yu-Liang Li, MD, Chief Doctor, Professor, Department of Interventional Medicine, The Second Hospital of Shandong University; Interventional Oncology Institute of Shandong University, No. 247, Beiyuan Road, Jinan 250033, Shandong Province, China. lyl.pro@sdu.edu.cn
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v26.i27.3929