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Endoscopy 1987; 19(1): 24-27
DOI: 10.1055/s-2007-1018221
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© Georg Thieme Verlag KG Stuttgart · New York

Transcholecystic Endoscopic Choledocholithotripsy: Successful Management of Retained Common Bile Duct Stone

M.-H. Hwang1 , H. H. Lee2 , J. Lin1 , J.-C. Yang3 , S.-K. Yueh4
  • 1From the Department of Surgery, University of Michigan Hospitals and Medical Center, Ann Arbor, Michigan, U.S.A.
  • 2Show Chwan Memorial Hospital, Changhwa, Taiwan, R.O.C., and the Division of Gastroenterology
  • 3The Department of Medicine, University of Michigan Hospitals and Medical Center, Ann Arbor, Michigan, U.S.A.
  • 4The Department of Radiology, University of Michigan Hospitals and Medical Center, Ann Arbor, Michigan, U.S.A.
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Publication History

Publication Date:
17 March 2008 (online)

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Summary

Removal of large common bile duct stones has been a continuing challenge. The feasibility and efficacy of transcholecystic endoscopic choledocholithotripsy in a high-risk patient are demonstrated in this report. The procedure requires an established cholecystostomy track, catheter dilatation of the cystic duct, and the application of electrohydraulic shock waves to the calculus. The use of a choledochofiberscope permits the passage of the electrohydraulic probe and minimizes complications by direct monitoring. Stone fragments are removed by basket retrieval. This procedure in conjunction with minicholecystostomy may obviate the need for surgery in selected high-risk patients with combined gallbladder and common bile duct stones.

Key words:

Transcholecystic choledocholithotripsy

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