Comparison on effects of PTOBF and PTCS in treatment of intrahepatic bile duct stones

LI Yong-bo; HUANG Mao-sheng; LI Huai-yang; CHEN Chen

doi:10.11659/jjssx.01E026009

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Comparison on effects of PTOBF and PTCS in treatment of intrahepatic bile duct stones

Clinical Research | 更新时间：2026-10-26

- Comparison on effects of PTOBF and PTCS in treatment of intrahepatic bile duct stones
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 919-922(2026)
- 作者机构：
  
  江苏省人民医院宿迁医院/宿迁市第一人民医院肝胆胰外科，江苏宿迁 223800
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E026009
  CLC： R657.4
- Received：05 January 2026，
  
  Revised：2026-09-17，
  
  Accepted：20 March 2026，
  
  Published：25 October 2026
- 稿件说明：
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李永波,黄茂盛,李怀阳等.PTOBF与PTCS治疗肝内胆管结石的疗效对比[J].局解手术学杂志,2026,35(10):919-922.

LI Yong-bo,HUANG Mao-sheng,LI Huai-yang,et al.Comparison on effects of PTOBF and PTCS in treatment of intrahepatic bile duct stones[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):919-922.
李永波,黄茂盛,李怀阳等.PTOBF与PTCS治疗肝内胆管结石的疗效对比[J].局解手术学杂志,2026,35(10):919-922. DOI： 10.11659/jjssx.01E026009.

LI Yong-bo,HUANG Mao-sheng,LI Huai-yang,et al.Comparison on effects of PTOBF and PTCS in treatment of intrahepatic bile duct stones[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):919-922. DOI： 10.11659/jjssx.01E026009.

摘要

目的

比较传统分期经皮经肝胆道镜取石术（PTCS）与经皮经肝Ⅰ期胆道造瘘取石术（PTOBF）治疗肝内胆管结石的效果与安全性。

方法

回顾性纳入2020年8月至2025年2月本院收治的肝内胆管结石患者85例，根据手术方式将其分为PTOBF组（44例）与PTCS组（41例）。比较2组患者第1次取石操作时间、中转开腹率、术后住院时间、总结石取净率、取石次数、白细胞计数（WBC）、C反应蛋白（CRP）、术后并发症发生率及术后6个月结石复发率。

结果

2组均无中转开腹病例。与PTCS组比较，PTOBF组患者第1次取石操作时间及术后住院时间更短（

0.05），取石次数更少（

0.05），总结石取净率更高（

0.05）。术后第1天，PTOBF组患者WBC、CRP水平均显著低于PTCS组（

0.05）。PTOBF组患者术后并发症总发生率低于PTCS组（

0.05）。2组患者术后6个月的结石复发率比较，差异无统计学意义（

0.05）。

结论

与分期PTCS相比，PTOBF治疗肝内胆管结石能显著缩短手术时间与住院时间，提高结石取净率，减少取石次数，减轻术后全身炎症反应，并降低术后近期并发症发生率，是一种更高效、微创的治疗选择。

Abstract

Objective

To compare the effects and safety of traditional staged percutaneous transhepatic cholangioscopy （PTCS） and percutaneous transhepatic one-step biliary fistulation （PTOBF） in the treatment of intrahepatic bile duct stones.

Methods

A total of 85 patients with intrahepatic bile duct stones admitted to our hospital from August 2020 to February 2025 were retrospectively included. They were divided into the PTOBF group （44 cases） and the PTCS group （41 cases） according to the surgical methods. The first stone removal operation time，conversion to laparotomy rate，postoperative hospital stay，whole stone free rate，stone removal frequency，white blood cell count （WBC），C-reactive protein （CRP），incidence of postoperative complications and stone recurrence rate at 6 months after surgery were compared between the two groups of patients.

Results

There were no cases with conversion to laparotomy in both groups.Compared with the PTCS group，the first stone removal operation time and postoperative hospital stay of patients in the PTOBF group were shorter （

0.05）， the stone removal frequency was fewer （

0.05）， and the whole stone free rate was higher （

0.05）. On the first day after the operation， the levels of WBC and CRP of patients in the PTOBF group were significantly lower than those in the PTCS group （

0.05）. The total incidence of postoperative complications in the PTOBF group was lower than that in the PTCS group （

0.05）. There was no statistically significant difference in the stone recurrence rate between the two groups of patients 6 months after surgery （

0.05）.

Conclusion

Compared with staged PTCS，PTOBF in the treatment of intrahepatic bile duct stones can significantly shorten the surgical time and hospital stay，improve the stone free rate，reduce the stone removal frequency，relieve the postoperative systemic inflammatory response，and reduce the incidence of postoperative short-term complications. Therefore，PTOBF is a more efficient and minimally invasive treatment option.

关键词

Keywords

references

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