Radiologic methods of bile duct stone extraction.
Fluoroscopically guided extraction of retained common duct calculi through a T-tube tract has a high success rate, low complication rate, and negligible mortality rate. It is not unduly uncomfortable and can be performed on an outpatient basis. The only disadvantage is a wait of approximately 6 weeks after surgery to let the T-tube sinus tract mature. If no T tube is present, endoscopic sphincterotomy is usually the treatment of choice. In difficult cases, the radiologist may be able to assist the endoscopist by placing a wire across the sphincter through a percutaneous transhepatic route. If endoscopic sphincterotomy is not successful or feasible, an attempt at percutaneous stone removal can be made from a transhepatic approach. A variety of new devices and dissolution agents is becoming available for stone fragmentation or reduction.
Geisinger
M A
MA
Department of Hospital Radiology, Cleveland Clinic Foundation, Ohio 44195-5103.
Owens
D B
DB
Meaney
T F
TF
D001649:Bile Duct Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D002404:Catheterization / Q000295:instrumentation; D002408:Catheters, Indwelling; D002758:Cholangiography; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D004724:Endoscopy; D004867:Equipment Design; D006801:Humans; D012008:Recurrence; D012086:Reoperation; D013525:Surgical Instruments