ĐÁNH GIÁ ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ NỘI SOI ĐƯỜNG MẬT QUA ĐƯỜNG HẦM KEHR Ở BỆNH NHÂN CÒN SỎI SAU PHẪU THUẬT LẤY SỎI ĐƯỜNG MẬT

Abstract

Objective: To describe clinical, paraclinical, and cholangioscopic features in patients with residual bile duct stones undergoing cholangioscopy via a Kehr T-tube tract at Binh Dan Hospital.

Methods: A retrospective descriptive study of 207 patients who underwent T-tube tract cholangioscopy at the Hepatobiliary Department, Binh Dan Hospital, from January 2022 to April 2025. Collected variables included demographics, comorbidities and ASA class, pre-cholangioscopy ultrasound and T-tube cholangiography, and endoscopic findings (tract maturation, stone location/burden, obstruction, and inflamed/easily bleeding mucosa). Descriptive analysis was performed.

Results: Mean age was 59.46 ± 13.85 years; 64.3% were female. Most patients had no comorbidities (76.3%); ASA II and III accounted for 84.1% and 15.0%, respectively. On ultrasound, intrahepatic stones accounted for 60.9%, extrahepatic/CBD stones 12.1%, and combined lesions 27.0%. The tract was mature in 96.7% of cases. Obstructive stones were present in 20.3%. At cholangioscopy, intrahepatic stones were seen in 47.4%, extrahepatic stones 33.8%, and combined lesions 18.8%; <5 stones in 64.3% and staghorn stones in 7.2%. Inflamed and easily bleeding bile ducts were noted in 10.1%.

Conclusions: Patients undergoing T-tube tract cholangioscopy were predominantly elderly females with ASA II–III. Intrahepatic stones predominated, while most tracts were well matured, facilitating endoscopic access.