Adjuncts and modifications to basket retrieval of retained biliary calculi

Although current techniques for percutaneous biliary stone extraction are highly successful, many patients require manipulation of the calculi before such extraction is possible. This article describes several adjunctive techniques for biliary stone retrieval that have proven to be effective. These include the modification of angiographic catheters for catheterization of ipsilateral ducts from the transhepatic approach, extractions of calculi from smaller ducts using constant irrigation and balloon catheters, and balloon-aided transampullary expulsion.