title: Contemporary "urologic" intervention in the pancreaticobiliary tree.
abstract: OBJECTIVE
  To evaluate the role of minimally invasive "urologic" interventional techniques for the treatment of pancreaticobiliary calculi in contemporary practice.
  
  
  METHODS
  Fourteen patients with retained cystic duct (n = 2), hepatic duct (n = 5), common duct (n = 2), pancreatic duct (n = 4), or gallbladder (n = 1) calculi were treated with 19 procedures, including shock wave lithotripsy (n = 9) and percutaneous flexible endoscopy with electrohydraulic or holmium laser lithotripsy (n = 10). Previous attempts using standard gastroenterologic or radiologic interventions before the urologic referral had failed in all 14 patients.
  
  
  RESULTS
  A successful result, defined by the resolution of stones and symptoms, was achieved in 12 patients (86%); 2 patients (14%) had residual calculi that ultimately required an open operative procedure. The hospital stay for each intervention was 0 to 2 nights, and no patients had any significant complications.
  
  
  CONCLUSIONS
  Even in this age of advanced gastroenterologic technology, including laparoscopic cholecystectomy, endoscopic retrograde cholangiopancreatoscopy, and percutaneous transhepatic cholangiography, the urologist can play a significant role in the minimally invasive treatment of patients with complicated biliary disease such that the need for open operative "salvage" procedures will be further minimized.
authors.affiliation: Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Ponsky
authors.forename: M A
authors.initials: MA
authors.lastname: Geisinger
authors.forename: J L
authors.initials: JL
authors.lastname: Ponsky
authors.forename: S B
authors.initials: SB
authors.lastname: Streem
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D002137:Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D002758:Cholangiography / Q000379:methods; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D020709:Ureteroscopes