RESULTS OF BILIARY DILATION AND STONE REMOVAL VIA FLEXIBLE CHOLANGIOSCOPY FOR THE TREATMENT OF PRIMARY BILIARY STRICTURES AND STONES AT MILITARY HOSPITAL 103

Tóm tắt

Objectives: To evaluate the results of biliary dilation and stone removal via flexible cholangioscopy for the treatment of primary biliary strictures (BS) and stones. Methods: A prospective, descriptive, uncontrolled study was conducted on 62 patients with primary BS and stones treated by biliary dilation and stone removal via flexible cholangioscopy at Abdominal Surgery Centre, Military Hospital 103, from July 2021 to July 2024. Results: The mean age was 60.1 ± 14.1; the female/male ratio was 1.69/1. 75.8% of patients had a history of biliary stones. Most patients had multiple stones (79%), including choledocholithiasis and hepatolithiasis. BS were mostly in one location (90.3%), intrahepatic strictures (88.7%), and were all benign. The mean length and diameter of the strictures were 3.96 ± 2.9mm and 3.6 ± 0.7mm, respectively. Surgical methods were choledochotomy with intraoperative cholangioscopy (90.3%) and percutaneous cholangioscopy (9.7%). Stone removal was performed using baskets, electrohydraulic, and/or laser lithotripsy. BS was performed using balloon dilation; then, biliary-cutaneous stents were placed in 64.5% of cases at risk of recoil. Intraoperative complications accounted for 16.1%; postoperative complications accounted for 12.9%. The rate of stone clearance and successful stricture dilation after surgery was 83.9% and 87.1%. Rechecked at 1 month, 3 months, and 6 months after operation, the ratio of recurrent stones and BS was 0%, 0%, 5.8% and 1.9%, 7.4%, 11.1%, respectively. Conclusion: Stone removal and stricture dilation by flexible cholangioscopy is a safe and effective method for treating primary BS and stones.