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Percutaneous choledochoscopic biliary tract stone removal: experience in 645 consecutive patients
1Department of Surgery, Show Chwan Memorial Hospital, Chang Hwa, Taiwan, ROC.
European Journal of Radiology
|November 1, 1993
Summary
Postoperative choledochoscopy (POC) and percutaneous transhepatic cholangioscopy (PTCS) are effective for biliary tract stone removal. Both methods show high success rates with minimal complications, offering distinct clinical applications.
Area of Science:
- Gastroenterology and Hepatology
- Minimally Invasive Surgery
- Interventional Endoscopy
Background:
- Retained biliary tract stones pose a significant clinical challenge.
- Non-operative retrieval methods are preferred to minimize patient morbidity.
Purpose of the Study:
- To present experience with percutaneous transhepatic cholangioscopy (PTCS) and postoperative choledochoscopy (POC) for biliary stone removal.
- To compare the efficacy and technical difficulties of transhepatic and T-tube routes.
- To evaluate the role of Dormia basket and electrohydraulic lithotripsy (EHL).
Main Methods:
- Retrospective analysis of 103 PTCS and 542 POC procedures.
- Utilized Dormia basket and electrohydraulic lithotripsy (EHL) for stone extraction.
- Compared outcomes based on transhepatic and T-tube access routes.
Main Results:
- High success rates achieved: 96% for POC and 97% for PTCS.
- No procedure-related mortality observed.
- Intrahepatic duct angulation and strictures were primary causes of failure.
Conclusions:
- Postoperative choledochoscopy (POC) is a safe and preferred method for retained biliary stones.
- Percutaneous transhepatic cholangioscopy (PTCS) is indicated for high-risk patients, including those with prior biliary surgery.
- Both POC and PTCS have distinct indications and clinical applications in managing biliary calculi.