Percutaneous transhepatic cholangioscopy and electrohydraulic lithotripsy for bile duct stones

Percutaneous transhepatic cholangioscopy in combination with intracorporeal electrohydraulic lithotripsy was successfully applied in 3 patients with biliary tract stones which could not be removed by endoscopic techniques. In a fourth patient, cholangioscopy was used as a diagnostic tool for the evaluation of a right hepatic duct stenosis above a hepatico-jejunostomy. The percutaneous transhepatic tract was dilated up to an 18-French size over a period of 1 week. Maturation of the tract was then awaited for another week before cholangioscopic procedures were started. The only complication noticed consisted of haemobilia that occurred in 1 patient after introduction of the initial percutaneous external-internal drainage catheter. Percutaneous cholangioscopy is a promising new technique in our diagnostic and therapeutic strategy in patients with complex biliary tract disorders.