Common bile duct and intrahepatic stones: results of transhepatic electrohydraulic lithotripsy in 50 patients.

• DOI: 10.1148/radiology.180.2.2068295
• Publication Date: 2014-07-08T20:53:42Z
• Authors: D H Bonnel; C E Liguory; F E Cornud; J F Lefebvre
• Keywords: Perforation; Intrahepatic bile ducts; Biliary fistula; Clearance

Percutaneous, transhepatic, intracorporeal, electrohydraulic shock wave lithotripsy was performed in 50 patients after failure of endoscopic treatment (n = 43) or directly with a strictured hepaticojejunostomy 7). Twenty-seven had common bile duct stones; 23, intrahepatic stones. Three steps were used: A transhepatic bilicutaneous fistula created, wide communication between the and gut established, contact under guidance. Afterward, 46 free In four diffuse lithiasis, only 75% stones could be cleared. Severe complications, seen 11 (hemobilia necessitating transfusion [n 6], perforation resulting cholangitis 3], acute pulmonary edema 1], hemothorax 1]), fatal patients; all occurred early study. The authors modified their technique by dilating biliary tract two sessions 3 days apart, waiting 6 for to mature, then introducing cholangioscope through skin, significantly reducing complications mortality (P less than .005).