关键词: 经皮经肝胆管穿刺引流, 经皮胆囊碎石, 胆总管结石, 胆囊结石

Abstract:

Objective To investigate the efficacy of percuteneous transhepatic cholangio drainage(PTCD) combined with the percutaneous gallbladder lithotripsy in the treatment of gallbladder stones combined with common bile duct stones. Method Clinical data from 43 patients with gallbladder stones and common bile duct stones treated between January and November 2024 in Nanjing Hospital Affiliated to Nanjing Medical University were collected. All patients underwent PTCD combined with percutaneous gallbladder lithotripsy for stone clearance. The clinical characteristics of the 43 patients were evaluated, and operative time, postoperative ventilation time, and hospital stay were recorded. Liver function indicators [alkaline phosphatase (ALP), total bilirubin (TBIL), aspartate aminotransferase (AST)] were assessed. The stone clearance rate was calculated, and stone recurrence and complications within 6 months postoperatively were recorded. Result The mean operative time was (114.31±18.74) min, postoperative ventilation time was (18.45 ± 2.52) h, and mean hospital stay was (5.96±1.32)d. All patients were discharged successfully. During postoperative recovery, total bilirubin levels decreased significantly at 24h postoperatively, followed by alkaline phosphatase and aspartate aminotransferase, and all returned to normal levels by 4 weeks postoperatively, with no cases of liver function deterioration. Among the 43 patients, 6 had mild biliary tract infection, 3 experienced biliary bleeding without other typical symptoms, and 1 developed acute suppurative cholangitis 12 h postoperatively, which improved after symptomatic treatment. In 4 patients with stones ≥ 20mm in diameter, magnetic resonance cholangiopancreatography confirmed successful one-time stone removal. No stone recurrence was observed in any patient, and 1 patient developed cholangitis. Conclusion PTCD combined with the percutaneous gallbladder lithotripsy demonstrates favorable clinical effi cacy in the treatment of gallbladder stones combined with common bile duct stones, with a high stone clearance rate and no severe complications.

Key words: Percuteneous transhepatic cholangio drainage, Percutaneous gallbladder lithotripsy, Common bile duct stones, Gallbladder stones