Contemporary "urologic" intervention in the pancreaticobiliary tree

Objectives. To evaluate the role of minimally invasive "urologic" intervent ional techniques for the treatment of pancreaticobiliary calculi in contemp orary practice. Methods. Fourteen patients with retained cystic duct (n = 2), hepatic duct (n = 5), common duct (n = 2), pancreatic duct (n = 4), or gallbladder (n = 1) calculi were treated with 19 procedures, including shock wave lithotrips y (n = 9) and percutaneous flexible endoscopy with electrohydraulic or holm ium laser lithotripsy (n = 10). Previous attempts using standard gastroente rologic or radiologic interventions before the urologic referral had failed in all 14 patients. Results. A successful result, defined by the resolution of stones and sympt oms, was achieved in 12 patients (86%); 2 patients (14%) had residual calcu li that ultimately required an open operative procedure. The hospital stay for each intervention was 0 to 2 nights, and no patients had any significan t complications. Conclusions. Even in this age of advanced gastroenterologic technology, inc luding laparoscopic cholecystectomy, endoscopic retrograde cholangiopancrea toscopy, and percutaneous transhepatic cholangiography, the urologist can p lay a significant role in the minimally invasive treatment of patients with complicated biliary disease such that the need for open operative "salvage " procedures will be further minimized. UROLOGY 57: 21-25, 2001. (C) 2001, Elsevier Science Inc.