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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
Biliary duct stones: percutaneous transhepatic removal
1Department of Diagnostic Radiology, New England Deaconess Hospital, Boston, MA 02215.
Cardiovascular and Interventional Radiology
|August 1, 1990
Summary
Percutaneous transhepatic removal of common bile duct stones offers a high success rate (93%) for patients unsuitable for surgery. This minimally invasive technique effectively removes stones, providing a favorable alternative to traditional surgical interventions.
Area of Science:
- Gastroenterology and Hepatology
- Interventional Radiology
Background:
- Common bile duct stones pose significant health risks.
- Surgical intervention is often contraindicated or has failed in certain patient populations.
- Endoscopic retrograde cholangiopancreatography and papillotomy may not always be successful.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous transhepatic removal of common bile duct stones.
- To assess this method as an alternative for patients with contraindications to surgery or failed endoscopic procedures.
Main Methods:
- Percutaneous transhepatic approach utilizing a modified Dormia basket.
- Insertion of the basket to retrieve stones or fragments into the duodenum.
- Infusion of Monooctanoin or methyl tertiary butyl ether to aid stone dissolution or debris removal.
Main Results:
- A high success rate of 93% was achieved in 53 patients (57 procedures).
- The average duration for complete stone removal was 8.5 days.
- Morbidity and mortality rates were 12% and 4%, respectively.
Conclusions:
- Percutaneous transhepatic stone removal is a safe and effective treatment for common bile duct stones.
- It presents a favorable alternative to surgery, especially for high-risk patients or those with failed endoscopic treatments.
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