2021 Volume 35 Issue 1 Pages 5-11
Laparoscopic cholecystectomy was performed after percutaneous transhepatic gallbladder drainage in approximately 50% of cases with mild and 80% of cases with moderate acute cholecystitis in our hospital. Biliary drainage was transpapillary in 90%, percutaneous in 9%, and transpapillary and percutaneous in 1% of the cases. Endotoxin excretion into bile juice was observed in 90% of bile tract infection caused by gram-negative bacilli. For common bile duct stones, 99.8% were endoscopically treated, and the breakdown was 95% transpapillary and 5% percutaneous; 0.2% of cases were surgically treated. In the drainage of transpapillary treatment, there was no significant difference in the drainage effect between endoscopic biliary stenting and endoscopic nasobiliary drainage. The factors contributing to post-EST bleeding and pancreatitis were hypertension and small-incision EST, respectively. The incidence of post-EST bleeding in antithrombotic drug users was 9%, and the contributing factor was EST incision direction (11 o'clock direction). In percutaneous treatment, about 80% of the cases underwent stone removal after elctrohydraulic lithotripsy. The cumulative stone recurrence rate was 14% in 3 years; however, all recurrence stones could be removed under percutaneous transhepatic cholangioscopy.
