Effect and Course of Percutaneous Transhepatic Cholangioscopy in Intrahepatic Stone Related Complication after Liver Resection

Background/Aims: Percutaneous transhepatic cholangioscopy (PTCS) is an effective treatment used for intrahepatic stone in patients who have undergone hepatectomy. There are few reports on natural course in these patients. Thus, we report the long-term results. Methods: We conducted a retrospective study of 19 patients who underwent PTCS after hepatectomy at Samsung Medical Center between January 1998 and December 2014. We investigated patient characteristics and recurrence of biliary complications during follow up period. Then, we analyzed the factors related to recurrence. Results: Indications for PTCS were cholangitis, symptomatic stone, liver abscess and biliary dilatation. Complete stone removal was achieved in 12 patients (63.2%). After receiving PTCS, the recurrence of intrahepatic stone related complication occurred in 52.6% (10/19) of patients during a median follow-up of 4.9 years (range, 1.8-7.8). Complications were cholangitis (5/10, 50%), cholangitis with liver abscess (3/10, 30%), liver abscess (1/10, 10%) and symptomatic stone (1/10, 10%). On univariate analysis, factors including multiple stone involvement, complete stone removal and bile duct stricture were not significantly associated with recurrent biliary complications. Conclusions: PTCS is an effective treatment for complications of recurrent intrahepatic stones in patients who have undergone hepatectomy. However, long term follow-up is necessary because of the recurrence of biliary complications.