MỘT SỐ YẾU TỔ ẢNH HƯỞNG TỶ LỆ TÁI PHÁT SỎI SAU TÁN SỎI ĐƯỜNG MẬT TRONG VÀ NGOÀI GAN QUA DA BẰNG LASER GIAI ĐOẠN SAU HAI NĂM

Abstract

Purpose: Analysis of some factors affecting the stone recurrence rate in patients with intrahepatic and extrahepatic stones have undergone percutaneous transhepatic transhepatic cholangioscopy lithotripsy. Subjects and  methods: This study is a retrospective review of 59 patients had intrahepatic and common bile duct stones and treated using percutaneous transhepatic cholangioscopy lithotripsy from January 2020  to August 2022 at Radiology Center – Hanoi Medical University Hospital. Results:. The study was conducted on 65 patients to analyze some factors affecting the results (stone recurrence rate) of intrahepatic and extrahepatic bile duct lithotripsy after percutaneous laser lithotripsy in long-term, with a median follow-up period of 27 months (IQR 3-37), showing that the rate of Overall stone recurrence was 43 patients (66.2%). The risk factor for a higher rate of stone recurrence is biliary stricture (OR, 5.4; 95% CI, 1.7-17.3; p=0.03); cholangitis on imaging (OR, 4.7; 95% CI, 1.2-18.7, p= 0.033); liver damage (OR, 5.0; 95% CI, 1.5-16.4; p=0.006); stone distribution in the liver (OR, 9.5; 95% CI 1.7-51.3; p=0.005) and stone retention (p=0.00). Conclusion: factors such as biliary stenosis, cholangitis, liver damage, distribution of stones, and stone retention can contribute to increasing the rate of stone recurrence after treatment with TSDMQDL. Therefore, assessing the above factors before percutaneous transhepatic transhepatic cholangioscopy lithotripsy is necessary to predict long-term effectiveness and devise a treatment plan to reduce the recurrence rate.