Percutaneous Choledochoscopic Treatment of Intrahepatic Stones, Including Management of Associated Biliary Stenoses

Introduction

Percutaneous choledochoscopy was introduced as a method of removing intrahepatic stones in 1981 [1]. Percutaneous lithotomy using percutaneous transhepatic cholangioscopy (PTCS) has become one of the most important nonsurgical forms of treatment for hepatolithiasis. Although some authors [2] [3] have reported that this procedure is effective and safe, biliary strictures associated with retained and recurrent stones have also been described. The aim of the present study was to examine the relationship between the presence of strictures and the results of this form of treatment, such as the number of PTCS sessions required and the rate of stone recurrence. In addition, the efficacy, limitations, and risks of choledochoscopic lithotomy as a first-choice procedure were reviewed in an unselected series. A new approach to the management of biliary strictures associated with hepatolithiasis is also described here.

References

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