Cholangioscopic extraction of intrahepatic stones associated with biliary strictures using a rendezvous technique.
Two patients with a severe biliary stricture of one intrahepatic duct and associated intrahepatic stones were successfully treated after dilatation of their stricture by a new endobiliary rendezvous technique with the aid of percutaneous transhepatic cholangioscopy (PTCS). The strictured bile duct was approached from a contralateral percutaneous tract via PTCS and from the diseased duct by introducing a guidewire. This guidewire was then extracted through the other side using a PTCS-guided biopsy forceps to form a communication between both sides which could be used as a pathway for subsequent dilatation. Our technique allows the extraction of intrahepatic stones even in the presence of biliary strictures.
Maetani
I
I
Department of Internal Medicine III, Toho University, School of Medicine, Tokyo, Japan.
Hoshi
H
H
Ohashi
S
S
Yoshioka
H
H
Sakai
Y
Y
D000328:Adult; D000368:Aged; D001653:Bile Ducts, Intrahepatic; D002769:Cholelithiasis / Q000150:complications / Q000628:therapy*; D002780:Cholestasis, Intrahepatic / Q000209:etiology*; D004106:Dilatation / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans