ĐÁNH GIÁ KẾT QUẢ NONG ĐƯỜNG MẬT LẤY SỎI QUA NỘI SOI ĐIỀU TRỊ SỎI CÓ HẸP ĐƯỜNG MẬT CHÍNH TẠI BỆNH VIỆN QUÂN Y 103

Abstract

Objectives: To evaluate the outcomes of biliary dilation and stone removal using flexible cholangioscopy in the treatment of primary bile duct stones and biliary strictures. Methods: A prospective, descriptive study was conducted on 62 patients diagnosed with main bile duct stones accompanied by biliary strictures at Military Hospital 103, from July 2022 to December 2024. Results: There were 62 patients with a female/male ratio of 1.69/1. The majority of stones were multi-granular (79%). Most biliary strictures were located intrahepatically (88.7%) and benign. The mean length and diameter of the strictures were 3.96 ± 2.9mm and 3.6 ± 0.7mm, respectively. Surgical approaches included choledochotomy with intraoperative cholangioscopy in 90.3% of cases, and percutaneous cholangioscopy in 9.7%. All biliary strictures were managed using balloon dilatation, and then biliary-cutaneous stents were placed in 64.5% of patients. Intraoperative complications occurred in 16.1% of cases, while postoperative complications were observed in 12.8%. The rates of complete stone clearance and successful stricture dilation postoperatively were 83.9% and 87.1%, respectively. On follow-up at 1, 3, and 6 months, the recurrence rates of bile duct stones were 0%, 0%, and 5.8%, while recurrence of biliary strictures occurred in 1.9%, 7.4%, and 11.1% of cases, respectively. The number, length, and diameter of biliary strictures were factors related to the rate of stone and biliary stricture clearance. Conclusion: Biliary dilation and stone removal using flexible cholangioscopy is an effective and safe method for the treatment of primary bile duct stones and biliary strictures.