Kết quả nội soi tán sỏi điện thuỷ lực qua đường hầm kehr tại Bệnh viện Đại học Y Hà Nội

Abstract

Background: Biliary tract stones are common and complex in Vietnam, with a very high rate of retained stones after the primary surgery. The introduction of electrohydraulic lithotripsy (EHL) via the T-tube (Kehr) tract has emerged as a minimally invasive and highly effective approach.  This study aimed to evaluate the outcomes of this technique at Hanoi Medical University Hospital. Subject and method: A descriptive retrospective study was conducted on 40 patients with retained biliary stones who retained a T-tube and underwent EHL at Hanoi Medical University Hospital from January 2018 to June 2025. The minimum interval from primary surgery to lithotripsy was 3 weeks. Main outcome measures included stone clearance rate, number of procedures, and perioperative complications. Result: The mean age was 57.9 ± 15.4 years, with males accounting for 57.5%. Abdominal pain was the most common symptom (35%). The mean interval from surgery to lithotripsy was 5.57 ± 2.10 weeks, with 90% of patients treated within 4 - 8 weeks. Stones were predominantly located intrahepatically (57.5%) or in both intra- and extrahepatic ducts (15%). A well-established T-tube tract was achieved in 100% of cases. Most patients required only a single session (90%), with a mean of 1.15 ± 0.2 sessions. The complete stone clearance rate was 92.5%. No intraoperative complications occurred. Postoperatively, one case of liver abscess (2.5%) was recorded and successfully managed with conservative medical treatment. The mean post-procedural hospital stay was 3.03 ± 1.68 days. Conclusion: Electrohydraulic lithotripsy via the T-tube tract is a safe, minimally invasive, and highly effective treatment for patients with retained biliary tract stones.