Subscribe to RSS
Percutaneous Transhepatic Laser Lithotripsy for Biliary Stones in Patients with Altered Biliary Anatomy
Endoscopic retrograde cholangiopancreatography (ERCP) is the current treatment of choice in bile duct stones. Several factors such as variant anatomy of ampulla and surgical procedures like hepaticojejunostomy limit the success of ERCP in treating bile duct stones. Percutaneous transhepatic laser lithotripsy using interventional radiologic and endourologic techniques, which is uncommon, is a reasonable treatment option in such difficult cases. It is a minimally invasive, safe procedure accompanied by a high success rate, minimal morbidity, and a short hospital stay. We report our technique and experience in a series of three patients who underwent percutaneous transhepatic biliary drainage (PTBD) followed by percutaneous transhepatic laser lithotripsy in an attempt to avoid open surgery when ERCP was technically difficult.
18 May 2021 (online)
© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Williams E, Beckingham I, El Sayed G. et al. Updated guideline on the management of common bile duct stones (CBDS). Gut 2017; 66 (05) 765-782
- 2 Gupta P, Gupta J, Praveen KM. Imaging in Obstructive Jaundice: What a Radiologist Needs to Know before Doing a Percutaneous Transhepatic Biliary Drainage. J Clin Interv Radiol ISVIR 2020; 4 (01) 31-37
- 3 Tazuma S. Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol 2006; 20 (06) 1075-1083
- 4 Tsutsumi K, Kato H, Yabe S. et al. A comparative evaluation of treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy and peroral, short double-balloon enteroscopy. Therap Adv Gastroenterol 2017; 10 (01) 54-67
- 5 Ierardi AM, Fontana F, Petrillo M. et al. Percutaneous transhepatic endoscopic holmium laser lithotripsy for intrahepatic and choledochal biliary stones. Int J Surg 2013; 11 (Suppl. 01) S36-S39
- 6 Cheng JHM, Leung WK, Wong AHC. et al. Percutaneous transhepatic biliary stones removal- An effective and safe alternative. Hong Kong J Radiol 2020; 23: 106-113
- 7 Lee JH, Kim HW, Kang DH. et al. Usefulness of percutaneous transhepatic cholangioscopic lithotomy for removal of difficult common bile duct stones. Clin Endosc 2013; 46 (01) 65-70
- 8 Healy K, Chamsuddin A, Spivey J, Martin L, Nieh P, Ogan K. Percutaneous endoscopic holmium laser lithotripsy for management of complicated biliary calculi. JSLS 2009; 13 (02) 184-189
- 9 Shamamian P, Grasso M. Management of complex biliary tract calculi with a holmium laser. J Gastrointest Surg 2004; 8 (02) 191-199
- 10 Tripathi N, Mardini H, Koirala N, Raissi D, Emhmed Ali SM, Frandah WM. Assessing the utility, findings, and outcomes of percutaneous transhepatic cholangioscopy with Spyglass Direct visualization system: a case series. Transl Gastroenterol Hepatol 2020; 5: 12