Single-centre retrospective analysis: 16 cases of percutaneous nephrolithotripsy complicating hepatic puncture injury in a 7-year experience

The aim of this retrospective analytical study was to investigate the diagnosis and management of liver puncture injuries caused by percutaneous nephrolithotripsy (PCNL).

The clinical data of 1069 patients who underwent PCNL between Oct. 2017 and Apr. 2024 were analyzed. The diagnosis of liver puncture injury was confirmed by postoperative examination of three-dimensional reconstruction computed tomography (3D-CT) findings, and the data from these patients were statistically and retrospectively analyzed.

A total of 16 cases were collected, including 9 males and 7 females, with an average age of 58.31 ± 14.30 years, a mean body mass index (BMI) of 23.54 ± 3.88 kg/m². Liver puncture injury was identified and classified as tangential or penetrating according to the anatomy of the nephrostomy tube and liver. The average decrease in hemoglobin level after operation was 14.25 ± 11.97 g/L. One patients received blood transfusions for preoperative anemia and postoperative blood loss, and all patients were cured and discharged after delaying the removal of nephrostomy tube under conservative treatment, the time of nephrostomy tube removal after a single PCNL procedure was 6.44 ± 1.26 days.

This article proposes a grading system for PCNL-complicated liver puncture injuries that will help physicians to better understand their characteristics and guide the development of management. In the absence of obvious signs of peritonitis and hemodynamic stability, conservative treatment of the liver puncture injury caused by PCNL is safe and effective.