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Related Experiment Videos

Percutaneous transhepatic cholangioscopic lithotripsy.

M F Chen1, Y Y Jan

  • 1Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.

The British Journal of Surgery
|May 1, 1990
PubMed
Summary
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Percutaneous transhepatic cholangioscopic lithotripsy effectively fragments large bile duct stones. Electrohydraulic shock wave lithotripsy is a safe and efficient method for stone removal.

Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Biliary Tract Interventions

Background:

  • Large intrahepatic and common bile duct stones pose challenges for removal.
  • Standard percutaneous transhepatic cholangioscopy may be insufficient for large calculi.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous transhepatic cholangioscopic lithotripsy for large bile duct stones.
  • To compare electrohydraulic shock wave lithotripsy with NdYAG laser lithotripsy.

Main Methods:

  • Percutaneous transhepatic cholangioscopic lithotripsy was performed on 14 patients with large bile duct stones.
  • Stones were fragmented using electrohydraulic shock waves or NdYAG laser.
  • Fragmented stones were removed via transhepatic cholangioscopy.

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Main Results:

  • Complete stone fragmentation was achieved in 7 cases (6 intrahepatic, 1 common bile duct).
  • Partial disruption occurred in 5 cases with intrahepatic stones.
  • Electrohydraulic shock wave lithotripsy showed effectiveness with minor complications (haemobilia, fever).
  • NdYAG laser was found to be expensive and inconvenient.

Conclusions:

  • Percutaneous transhepatic cholangioscopic lithotripsy, particularly with electrohydraulic shock waves, is an effective and safe method for fragmenting and removing large bile duct stones.
  • Intrahepatic duct angulation and stricture were identified as factors contributing to treatment failure.