Choledochoscopic Stone Removal through a T-Tube Tract: Experience in 75 Consecutive Patients

Bruce L. Bower, Daniel Picus, Marshall E. Hicks, Michael D. Darcy, Edward S. Rollins, Michael A. Kleinhoffer, Philip J. Weyman

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Retained biliary stones remain a common clinical problem in patients after surgery. Since 1984, the authors have used choledochoscopy in the treatment of suspected retained biliary stones in 75 patients. These procedures were performed in the radiology department with use of local anesthesia supplemented by an intravenously administered sedative and analgesic. A 15-F flexible fiberoptic choledochoscope was used. Fifty-one of the 75 patients were treated as outpatients. Treatment was successful in 74 of 75 patients; in one patient, intrahepatic stones were not completely removed. Electrohydraulic lithotripsy was used to fragment calculi in 11 patients (15%). Biopsies were performed in four patients (5%). Five minor complications occurred; three required overnight admission. Choledochoscopic-assisted removal of retained biliary calculi is a highly effective and safe procedure. Advantages over standard fluoroscopic stone removal include the ability to directly visualize and fragment adherent or impacted stones and visualize noncalculous filling defects, such as air bubbles, mucus, and biliary tumors.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume1
Issue number1
DOIs
StatePublished - Jan 1 1990
Externally publishedYes

Keywords

  • Bile ducts, calculi, 76.289
  • Bile ducts, stone extraction, 76.1228
  • EHL
  • Endoscopy, 76.1229
  • electrohydraulic lithotripsy

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