A novel technique of percutaneous stone extraction in choledocholithiasis after cholecystostomy

Hepatogastroenterology. 2013 May;60(123):452-5. doi: 10.5754/hge12004.

Abstract

Background/aims: To evaluate the technical feasibility and clinical efficacy of percutaneous common bile duct stone extraction via cystic duct after percutaneous cholecystostomy.

Methodology: Twenty-five consecutive patients with choledocholithiasis underwent percutaneous stone extraction under conscious sedation. The stones were extracted through the 12-Fr sheath using Wittich nitinol stone basket under fluoroscopic guidance via cystic duct after percutaneous trnas-hepatic cholecystostomy.

Results: Common bile duct stones were successfully removed in 22 of the 25 patients (88%) by this new technique. The causes of failure in three patients were bile leakage, hematoma of the gallbladder and failure of cystic duct cannulation. Cystic duct injury during this procedure did not occur and there was no post-procedure mortality. The mean period of indwelling catheter was 8.7±4.6 days and the mean duration of hospitalization was 13.4±5.9 days.

Conclusions: Percutaneous commmon bile duct stone extraction via the cystic duct through percutaneous cholecystostomy route is effective and feasible for treating choledocholithiasis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization / adverse effects
  • Catheterization / methods*
  • Cholecystectomy, Laparoscopic
  • Cholecystostomy*
  • Choledocholithiasis / diagnostic imaging
  • Choledocholithiasis / therapy*
  • Conscious Sedation
  • Feasibility Studies
  • Female
  • Gallstones / diagnostic imaging
  • Gallstones / therapy*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Radiography, Interventional
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome