title: Percutaneous transhepatic cholelithotripsy for difficult common bile duct stones.
abstract: OBJECTIVE
  A study was carried out to assess the feasibility of a new rapid technique for percutaneous transhepatic access to the biliary tract with endoscopic lithotripsy (percutaneous transhepatic cholelithotripsy).
  
  
  METHODS
  14 patients with biliary stones resistant to endoscopic retrograde cholangiography and extracorporeal shock wave lithotripsy underwent cholelithotripsy, utilizing a new dilation kit with massive teflon dilators covered by "peel-away sheets".
  
  
  RESULTS
  Successful lithotripsy was performed in all patients by laser lithotripsy through a choledochoscope or ureteroscope in ten patients and by stone removal by basket in the remaining four patients. The procedure was carried out using local anesthesia in the last 11 patients. Except for two patients with transient cholangitis, no complications occurred.
  
  
  CONCLUSIONS
  Difficult bile duct and intrahepatic stones can be treated successfully with a simple percutaneous transhepatic cholelithotripsy procedure including local anesthesia, dilation and stone clearance.
authors.affiliation: Dept. of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.
authors.forename: J G
authors.initials: JG
authors.lastname: Stage
authors.forename: F
authors.initials: F
authors.lastname: Moesgaard
authors.forename: S
authors.initials: S
authors.lastname: Grønvall
authors.forename: P
authors.initials: P
authors.lastname: Stage
authors.forename: H
authors.initials: H
authors.lastname: Kehlet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D017211:Treatment Failure