CHOLANGIOSCOPIC EXTRACTION OF INTRAHEPATIC STONES ASSOCIATED WITH BILIARY STRICTURES USING A RENDEZVOUS TECHNIQUE

Two patients with a severe biliary stricture of one intrahepatic duct and associated intrahepatic stones were successfully treated after dil atation of their stricture by a new endobiliary rendezvous technique w ith the aid of percutaneous transhepatic cholangioscopy (PTCS). The st rictured bile duct was approached from a contralateral percutaneous tr act via PTCS and from the diseased duct by introducing a guidewire. Th is guidewire was then extracted through the other side using a PTCS-gu ided biopsy forceps to form a communication between both sides which c ould be used as a pathway for subsequent dilatation. Our technique all ows the extraction of intrahepatic stones even in the presence of bili ary strictures.