[Biliary lithiasis. Non-surgical treatment]

Between 1979 and 1989, forty-six patients with biliary lithiasis were treated by non-surgical methods. Jaundice was present in 32 (70%) patients. In five patients (11%), the bile stones were found during the routine ERCP for cholelithiasis. Five patients (11%) had stones with diameter of 30 mm and over. Clearing of biliary ducts was achieved in 44 patients (95.7%). Forty-five patients required endoscopic sphincterotomy, the other one, had a surgical sphincteroplasty performed at the time of cholecystectomy. The stones passed spontaneously in eight patients (17.4%), Dormia basket, shock-wave and mechanical lithotripsy, and contact chemical dissolution, alone or combined, were the methods of treatment. There were two faults (4.3%). In the first case, after the attempt to retrieve the stone with a Dormia basket, as no other method was available (1979), surgical treatment was done. The other case had multiple stones in the biliary tree located in both, intra and extrahepatic ducts. In this case, the use of all available procedures did not clear the biliary tract, so a surgical procedure was ordered. There was one complication (2.2%), a retroduodenal perforation that was treated medically. There was no mortality.