Radiologic Management of Problematic Biliary Calculi

Balloon catheter sphincteroplasty and biliary stone expulsion into the duodenum in patients with an indwelling T tube

“…The list of complications include fever, sepsis, sinus tract perforation, pancreatitis, cholangitis, bile peritonitis, bile collections, and vasovagal reactions. In the standard T-tube extraction technique, the T tube is 14 Fr or larger, a wait of 5-6 weeks after surgery is needed to let the T-tube sinus tract mature, and a variety of devices are used to remove the stones [1][2][3].…”

“…Endoscopic sphincterotomy and removal of the stones are the methCorrespondence to: J. Muchart ods of choice for treatment. This procedure is not feasible, however, when (a) the biliary duct cannot be accessed because of a duodenal diverticulum or previous gastrointestinal surgery or (b) the stone is larger than 15 mm, impacted, or difficult to locate (intrahepatic, bile duct diverticulum or associated with stenosis) [1]. In these cases percutaneous therapy is indicated before surgery.…”