[Percutaneous transhepatic disintegration of gallstones and fragment extraction]

Attempts at percutaneous removal have been made in 13 patients with solitary and multiple intra- and extra-hepatic biliary duct stones measuring 5 to 30 mm. The stones were fragmented with a Dormia basket and the fragments removed transhepatically. In ten patients the procedure was successful, including one patient with multiple intra-hepatic stones. The procedure can be recommended for cases of calculous obstruction of biliary anastomoses or of stones which could not be removed by endoscopy, or where there is already biliary drainage being carried out, or in patients with a high operative risk. In two patients, dilatation of the papilla was also carried out, in four patients a stenosis was dilated and in a further two patients, dilated and in a further two patients, electro-incision of a stenosis was performed.