Percutaneous treatment of complex biliary stone disease using endourological technique and literature review

Abstract

Most biliary stone diseases need to be treated surgically. However, in special cases that traditional biliary tract endoscopic access is not allowed, a multidisciplinary approach using hybrid technique with urologic instrumental constitute a treatment option. We report a case of a patient with complex intrahepatic stones who previously underwent unsuccessful conventional approaches, and who symptoms resolved after treatment with hybrid technique using an endourologic technology. We conducted an extensive literature review until October 2012 of manuscripts indexed in PubMed on the treatment of complex gallstones with hybrid technique. The multidisciplinary approach with hybrid technique using endourologic instrumental represents a safe and effective treatment option for patients with complex biliary stone who cannot conduct treatment with conventional methods.

Percutaneous transhepatic holmium laser lithotripsy of a large common bile duct stone

“…As shown by Patel et al. and other reports in the growing Urologic literature [4], [5], [6], gallstone lithotripsy using a holmium laser can be a reasonable and safe alternative for many patients. The interventional radiologist plays an active role in these cases.…”

Percutaneous Transhepatic Choledochoscopic Lithotomy (PTCSL) is Effective for the Treatment of Intrahepatic and Extrahepatic Choledocholithiasis

“…At present, the main treatment methods of bile duct stones include open surgery, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic choledochoscopic lithotomy (PTCSL), and laparoscopic lithotomy. 2 Traditional PTCSL uses a fiberoptic choledochoscope to remove stones. This method has some disadvantages, such as a long treatment cycle, low stone extraction efficiency and high economic pressure on patients, which has led to less and less use of traditional PTCSL all around the world.…”

“…Most choledocholithiasis requires surgical intervention. At present, the main treatment methods of bile duct stones include open surgery, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic choledochoscopic lithotomy (PTCSL), and laparoscopic lithotomy 2…”