ĐÁNH GIÁ TƯƠNG QUAN GIỮA HẸP ĐƯỜNG MẬT VÀ TỶ LỆ TÁI PHÁT SỎI Ở BỆNH NHÂN SAU TÁN SỎI ĐƯỜNG MẬT TRONG VÀ NGOÀI GAN QUA DA BẰNG LASER

Abstract

Purpose: to evaluating the correlation between stone recurrence rate and biliary stenosis in patients with intrahepatic and extrahepatic stones, treated by percutaneous transhepatic cholangioscopy lithotripsy. Subjects and  methods: a retrospective study in 59 patients having intrahepatic and extrahepatic lithiasis, treated by using percutaneous transhepatic cholangioscopy lithotripsy from January 2020  to August 2022 at Radiology Center – Hanoi Medical University Hospital. Results:. The study included 59 patients with intrahepatic and/or extrahepatic stones who had undergone percutaneous laser lithotripsy, were divided into two groups with biliary stenosis ( 61%, 36 patients) and without biliary stenosis (39%, 23 patients). The median time  follow-up was 26,7 months (IQR 3-37), stone recurrence rater were 66,1% (39 patients). The research shows that there is an association between biliary stenosis and stone recurrence rate (p=0,002). We found that biliary stenosis from 45,1% has a predictive value for the possibility of biliary stone recurrence with a sensitivity of 86% and a specificity of 66,7%. Thus, percutaneous laser biliary lithotripsy is most effective in patients without biliary stenosis with a long-term stone recurrence-free rate in 56,5% of patients compared to 22,2% of patients with biliary stenosis. Conclusion: Biliary stenosis is a risk factor of stone recurrence and biliary stenosis has the ability to predict the rate of biliary stone recurrence in patients after percutaneous transhepatic cholangioscopy lithotripsy. Therefore, assessing the biliary stricture is necessary to predict long-term effectiveness and devise a treatment plan to reduce the recurrence rate.