Percutaneous Lithotripsy for Removing Difficult Bile Duct Stones Using Endoscopy.
10.3348/jkrs.2008.58.3.229
- Author:
See Hyung KIM
1
;
Chul Ho SOHN
;
Young Hwan KIM
Author Information
1. Department of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Korea. chsohn@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Bile duct, calculi;
Cholelithiasis, gallstone;
Percutaneous lithotripsy
- MeSH:
Bile;
Bile Ducts;
Catheters;
Dioxolanes;
Drainage;
Endoscopy;
Fluorocarbons;
Humans;
Lithotripsy;
Nitroglycerin;
Sepsis;
SNARE Proteins
- From:Journal of the Korean Radiological Society
2008;58(3):229-236
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To describe efficacy of percutaneous lithotripsy for removing difficult bile duct stones using endoscopy. MATERIALS AND METHODS: A total of 88 patients with difficulties for the removal of bile duct stones using endoscopy (an impacted stone, stone size >15 mm, intrahepatic duct (IHD) stone, stone size to bile duct diameter ratio >1.0), were enrolled in this study. A 12 Fr sheath was inserted through the percutaneous transhepatic biliary drainage (PTBD) tract, and then nitrol stone baskets and a 0.035" snare wire were used to capture, fragment and remove the stones. The technical and clinical success rates were analyzed, together with an analysis of any complications. RESULTS: The overall technical success rate of stone removal was achieved in 79 of 88 patients (89.8%). In five of nine patients with failed stone removal, small residual IHD stones were noted on a cholangiogram. Even if stone removal failed in these cases, cholangitic symptoms were improved and the drainage catheter was successfully removed. Therefore, clinical success was achieved in 84 of 88 patients (95.5%). There were no significant procedure-related complications, except for sepsis in one case. CONCLUSION: Billiary stone removal using the stone basket and guide-wire snare technique through the PTBD tract is a safe and effective procedure that can be used as a primary method in patients with difficulties for the removal of bile duct stones using endoscopy.
