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Percutaneous transhepatic sphincterotomy--a report on 3 cases.
Endoscopy
|January 1, 1991
Summary
Percutaneous transhepatic sphincterotomy offers a successful alternative for treating common bile duct stones when endoscopic methods fail due to gastric surgery anatomy. This minimally invasive technique achieved complete success in all patients without major complications.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Hepatobiliary Surgery
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is the standard for common bile duct (CBD) stone removal.
- Anatomical alterations from gastric surgery, such as Billroth II resection, can impede successful ERCP.
- Alternative approaches are needed for patients with complex biliary anatomy and CBD stones.
Observation:
- Percutaneous transhepatic sphincterotomy (PTS) was performed in three patients with CBD stones.
- These patients had previously failed endoscopic procedures due to post-gastric surgery anatomy.
- The PTS procedure was technically successful in all cases.
Findings:
- Complete immediate clearance of CBD stones was achieved in all three patients.
- No major complications were observed during or after the transhepatic intervention.
- PTS provided an effective treatment pathway for challenging CBD stone cases.
Implications:
- PTS is a viable and safe alternative when ERCP is anatomically contraindicated.
- This technique expands treatment options for patients with biliary tree diseases and altered gastric anatomy.
- Elective use of PTS may improve outcomes for selected patients with difficult-to-treat CBD stones.