COMBINED PERCUTANEOUS BALLOON DILATION AND EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY FOR TREATMENT OF BILIARY STRICTURE AND COMMON BILE-DUCT STONES

We report a case of cholangitis, liver abscess, and common bile duct s tones in a patient with a benign stricture at a choledochojejunal anas tomosis, 3 yr after a complicated duodenohemipancreatectomy. Because s urgical reintervention seemed inappropriate, a percutaneous transhepat ic balloon dilation was performed after temporary internal-external bi liary drainage. Extracorporeal shockwave lithotripsy (ESWL) was succes sfully applied to fragment all common bile duct stones, with subsequen t spontaneous evacuation of all stone fragments through the dilated bi lioenteric anastomosis. Only one similar case report has been publishe d before (1), though with a different sequence of therapeutic modaliti es. Moreover, according to our literature review, this is the first re port of ESWL of common bile duct stones by means of the Dornier Compac t Lithotriptor (Dornier, Germany) with electromagnetic shockwave sourc e,