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Endoscopy Lithotomy for Intrahepatic Gallstones

A Meta-Analysis

Ma, Shumin MD*; Hu, Sanyuan MD*; Gao, Feng MS; Liang, Rui BS

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: August 2015 - Volume 25 - Issue 4 - p 269–274
doi: 10.1097/SLE.0000000000000138
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Background: Endoscopy lithotomy (percutaneous transhepatic cholangioscopic lithotomy or through a T-tube track) has become a well-established treatment for intrahepatic gallstones. However, the relationship between strictures and the results of this treatment is still controversial.

Materials and Methods: We searched PubMed, EMBASE, Cochrane Library databases, clinicaltrails, CBM, and Google scholar systematically for all articles. The rate of complete clearance, the recurrence rate, and major complications were analyzed. A meta-analysis was performed by RevMan 5.2.

Results: Thirteen studies were included. In patients with intrahepatic duct stricture, the rate of complete clearance was significantly lower, but the rate of recurrence was significantly higher. The morbidity rate of major complications was significantly lower in complete stone removal patients.

Conclusions: Intrahepatic biliary stricture is a major cause of treatment failure for intrahepatic stones and stone recurrence. To prevent recurrent cholangitis or cholangiocarcinoma, complete removal of intrahepatic gallstones is very important.

*Department of General Surgery, Qilu Hospital of Shandong University, Jinan

Department of General Surgery, Qingdao Hiser Hospital

Department of Obstetrics, Qingdao Women and Children’s Hospital, Qingdao, Shandong, People’s Republic of China

The authors declare no conflicts of interest.

Reprints: Shumin Ma, MD, Department of General Surgery, Qilu Hospital of Shandong University, #107 Wenhua Xi Road, Jinan, Shandong 250012, People’s Republic of China (e-mail: mashumin168@163.com).

Received August 20, 2014

Accepted January 22, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.