Retained biliary calculi: removal by a simple non-operative technique

Ten patients with retained biliary calculi demonstrated by postoperative T-tube cholangiography were managed by a simple nonoperative washout technique. The bile was cultured routinely before each group of washouts, since fever was a common sequel in the presence of infected bile. After a parenteral dose of propantheline bromide, the biliary tree was flushed through the T-tube with 1 litre of normal saline containing 40 ml of lignocaine. Progress was followed by T-tube cholangiography, and the criterion of success was a cholangiogram showing adequate filling of the biliary tree, absence of filling defects, and free flow of contrast medium into the doudenum. The technique was successful in six of the ten patients. There was no mortality and no significant morbidity.