PERCUTANEOUS CHOLEDOCHOSCOPIC BILIARY-TRACT STONE REMOVAL - EXPERIENCE IN 645 CONSECUTIVE PATIENTS

Our experience in non-operative retrieval of biliary tract stones thro ugh PTCS (percutaneous transhepatic cholangioscopy, n = 103) and POC ( post-operative choledochoscopy, n = 542) plus the use of Dormia basket and EHL (electrohydraulic lithotripsy) is presented. The results of t ranshepatic and T-tube routes are compared, with emphasis on the techn ical difficulties encountered. The success rates were 96% and 97% in P OC and PTCS, respectively. No mortality was related to these procedure s. Intrahepatic duct angulation and stricture were the factors most of ten responsible for failure. Postoperative choledochoscopic stone remo val is safe and the method of choice for retained biliary tract calcul i, while PTCS is highly indicated for those high-risk patients with or without previous biliary surgery. POC and PTCS have, therefore, their own indications and differ in their clinical applications.