Published online Jul 21, 2020. doi: 10.3748/wjg.v26.i27.3929
Peer-review started: May 6, 2020
First decision: May 21, 2020
Revised: May 24, 2020
Accepted: July 4, 2020
Article in press: July 4, 2020
Published online: July 21, 2020
The treatment of hepatolithiasis is complicated and difficult. Some patients cannot tolerate surgery due to severe cardiac or pulmonary comorbidities, or cannot be treated with endoscopy because of altered gastrointestinal anatomies.
Our previous experience indicated percutaneous transhepatic papillary balloon dilation (PTPBD) could be an alternative for common bile duct stones.
In this retrospective study, the clinical efficacy and safety of modified PTPBD were assessed for the removal of intrahepatic bile duct stones in patients with cardiopulmonary comorbidities or altered gastrointestinal anatomies.
Twenty-one patients with intrahepatic bile duct stones who underwent modified PTPBD were enrolled in this study. Outcomes, including success rate, cause of failure, complications, procedure time and hospital stay, were analyzed. Reflux cholangitis and calculi recurrence were recorded for 2 years.
The success rate was 95.23%. No pancreatitis or perforation occurred. No evidence of reflux cholangitis and calculi recurrence were observed for 2 years.
Modified PTPBD could be considered as a safe, feasible, and effective treatment option for intrahepatic bile duct stones in patients with cardiopulmonary comorbidities or altered gastrointestinal anatomies.
Multi-center prospective study should be conducted to compare modified PTPBD to surgery or endoscopic procedures to gain more evidence.