PERCUTANEOUS TRANSCYSTIC CHOLANGIOSCOPY FOR COMBINED TREATMENT OF GALLBLADDER AND BILE-DUCT STONES

A procedure for percutaneous transcystic cholangioscopy requiring only one percutaneous transhepatic fistulous tract to remove stones locate d in both the gallbladder and bile ducts is described. The procedure b egins with percutaneous transhepatic drainage of the gallbladder or bi le duct. Stones in the gallbladder and bile duct can be removed under direct vision on transhepatic cholangioscopy. Larger stones can be fra gmented by electrohydraulic lithotripsy before removal. In a prelimina ry trial the procedure proved to be a feasible method for treatment of 13 patients with both gallbladder and bile duct stones as well as sep tic cholangitis who either refused operation or were considered poor c andidates for surgery. On long-term follow-up (mean period 28 months) stone recurrence was observed in three patients.