Percutaneous transhepatic removal of common duct stones: report of ten patients

Ten patients aged 64-94 yr (mean 80 yr) underwent percutaneous transhepatic removal of common duct stones after endoscopic papillotomy and stone removal were judged to be contraindicated. The technique involved percutaneous placement of a modified Dormia basket in the common duct with its tip in the duodenum. The stones or fragments were then snared and carried into the duodenum. In 5 patients monooctanoin infusion was attempted after the basket procedure in order to remove sludge or fragments that resisted snaring or crushing. The stones were 0.5-2.5 cm in diameter. Symptoms disappeared in all 10 patients without further therapy. Complications included an abdominal wall abscess, an unexplained drop in hematocrit, a subcapsular hematoma, and one episode of pancreatitis. All complications resolved without further incident.