Efficacy analysis of percutaneous transhepatic biliary drainage and stone extraction for treating acute cholangitis caused by common bile duct stones in middle-aged and elderly patients
Chi Qingjie
Qian Jinhua
Shen Weiguang
Chen Zhuo
Jin Jie
Ding Wenbin
Abstract：Objective To investigate the safety and clinical efficacy of percutaneous transhepatic cholangiographic drainage(PTCD)combined with percutaneous transhepatic papillary balloon dilation(PTPBD)for the treatment of acute cholangitis(AC)caused by common bile duct(CBD)stones in elderly patients.Methods A retrospective analysis was conducted on the clinical data of 44 elderly patients(median age:76 years)with AC caused by CBD stones treated in our department.Patients underwent imaging examinations prior to surgery to confirm bile duct dilation or stone impaction.Emergency PTCD was performed under local anesthesia to drain the bile,followed by a second-stage PTPBD procedure to push the stones into the intestine.The effects of stone size on operative time,balloon dilation frequency,and complications were compared.Results Biliary drainage was successfully performed in all 44 patients,achieving a 100.00%success rate.Stone extraction via PTPBD was successfully completed in 43 patients,with a success rate of 97.67%(43/44 cases).Among them,8 patients underwent stone fragmentation with basket extraction,and 1 patient was deemed unsuitable for surgery due to an excessively large stone.Postoperative complications included mild hemobilia in 5 patients and elevated blood amylase levels in 7 patients.All complications were effectively managed with symptomatic treatment,with no severe outcomes.During a 6-month follow-up period,stone recurrence was observed in 1 case.Conclusion For elderly patients with CBD stones complicated by AC who are unsuitable for surgical or ERCP procedures,PTCD combined with second-stage biliary stone extraction is a safe and effective clinical treatment approach.
Keywords：Middle-aged and elderlyStonesAcute cholangitisPercutaneous transhepatic cholangiographic drainagePercutaneous transhepatic papillary balloon dilation
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 7-11 )