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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 05(03): 177-181
DOI: 10.1055/s-0041-1728985
Case Report

Percutaneous Transhepatic Laser Lithotripsy for Biliary Stones in Patients with Altered Biliary Anatomy

Jacob Indu 
1   Department of Interventional Radiology, Apollo Hospital, Bangalore, Karnataka, India
,
Vikrama Amitha Kheda
1   Department of Interventional Radiology, Apollo Hospital, Bangalore, Karnataka, India
,
Deepak Bolbandi
2   Department of Urology, Apollo Hospital, Bangalore, Karnataka, India
,
Sanjay Govil
3   Department of Gastrointestinal Surgery and Liver Transplantation, Apollo Hospital, Bangalore, Karnataka, India
,
Ravisankar Bhat
4   Department of Gastrointestinal Surgery, Apollo Hospital, Bangalore, Karnataka, India
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Abstract

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.

Keywords

percutaneous lithotripsy - biliary stones - holmium laser


Publication History

Article published online:
18 May 2021

© 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/).

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