PERCUTANEOUS TRANSHEPATIC CHOLELITHOTRIPSY FOR DIFFICULT COMMON BILE-DUCT STONES

Background and Study Aims: A study was carried out to assess the feasi bility of a new rapid technique for percutaneous transhepatic access t o the biliary tract with endoscopic lithotripsy (percutaneous transhep atic cholelithotripsy), Patients and Methods: 14 patients with biliary stones resistant to endoscopic retrograde cholangiography and extraco rporeal shock wave lithotripsy underwent cholelithotripsy, utilizing a new dilation kit with massive teflon dilators covered by ''peel-away sheets''. Results: Successful lithotripsy was performed in all patient s by laser lithotripsy through a choledochoscope or ureteroscope in te n patients and by stone removal by basket in the remaining four patien ts. The procedure was tarried out using local anesthesia in the last I I patients, Except for two patients with transient cholangitis, no com plications occurred. Conclusions: Difficult bile duct and intrahepatic stones can be treated successfully with a simple percutaneous transhe patic cholelithotripsy procedure including local anesthesia, dilation and stone clearance.