ĐIỀU TRỊ HẸP ĐƯỜNG MẬT LÀNH TÍNH KHU TRÚ BẰNG PHƯƠNG PHÁP NỘI SOI ĐƯỜNG MẬT XUYÊN GAN QUA DA ỨNG DỤNG LASER THULIUM

Abstract

Objective: To evaluate the initial results of percutaneous transhepatic cholangioscopic laser therapy (PTCLT) with Thulium laser for the treatment of benign focal biliary strictures (FBS). Subjects and methods: A retrospective and prospective observational study was conducted on 13 patients diagnosed with FBS and treated with PTCLT with Thulium laser from August 2020 to August 2022. Patients were evaluated at 6 months after treatment. Results: There were 10 females and 3 males, with a mean age of 46±19 years. The distribution of stricture location was as follows: 5/13 right hepatic duct, 4/13 left hepatic duct, 2/13 posterior segmental branch, and 2/13 inferior third branch. In 8/12 patients, stones were cleared before stricture ablation, and in 4/12 patients, stones were cleared after successful stricture ablation. The mean diameter of the stricture site before ablation was 2.04 ±1.35 mm, and the mean diameter of the stricture site immediately after the procedure was 8.48 ± 2.28 mm. Wilcoxon's test for comparing the diameters before and after stricture showed that the widening of the bile duct was statistically significant with a confidence level of 99%. Pain during the procedure was ≤3 points on the Visual Analogue Scale (VAS). Only 2/13 patients had mild bleeding complications that were successfully treated with medication. Two patients (2/13) had recurrent strictures after the intervention at 795 days and 634 days, respectively. Conclusion: PTCLT with Thulium laser is a safe and effective method for the treatment of FBS, with a low complication rate during the procedure (2/13 patients), a high success rate immediately after intervention (13/13 patients), and a low recurrence rate (2/13 patients).