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Updated: Aug 14, 2026
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
Percutaneous transhepatic small-caliber choledochoscopic lithotomy: a safe and effective technique for percutaneous
Kaoru Ogawa1, Hironao Ohkubo, Wataru Abe
1Department of Internal Medicine, Juntendo University Izunagaoka Hospital, 1129 Izunagaoka, Tagata, Shizuoka 410-2295, Japan.
Purpose:
Endoscopic bile duct clearance is now the treatment of first choice for bile duct stones, particularly in elderly or high-risk patients. The purpose of this study was to objectively assess the safety, efficiency, and ease of use of percutaneous transhepatic choledochoscopy, using a small-caliber choledochoscope with a facilitated insertion technique, in high-risk elderly patients with choledocholithiasis.
Methods:
Sixty-five consecutive patients with common bile duct stones scheduled for percutaneous transhepatic choledochoscopic lithotomy were studied prospectively. Choledochoscopy was carried out with a simplified introducer system, using a 2.8-mm choledochoscope with electrohydraulic lithotripsy.
Results:
The common bile duct was successfully accessed and the stones removed in all 65 patients. The average time for the entire procedure was 45 min. There were no serious procedure-related complications.
Conclusions:
Percutaneous transhepatic choledochoscopic lithotomy, using electrohydraulic lithotripsy, is an attractive alternative for patients with common bile duct stones when surgery or retrograde methods are not suitable.
