[New therapeutic alternatives for patients with gallstones]

Calculi in the bile ducts are usually removed by surgery or endoscopic papillotomy. When these methods are contraindicated or fail, new and non-surgical alternatives can now be used. Percutaneous transhepatic balloon dilatation of the papilla of Vater enables expulsion of stones in the bile duct. Large stones in the bile ducts can be reduced in size using extracorporeal shock waves or completely dissolved by instillations of Methyl-tertiary-butyl ether in the common bile duct. We report the cases of three patients who were treated successfully for stones in the bile duct using combinations of these techniques.