title: Minimally invasive management of biliary tract injury following percutaneous nephrolithotomy.
abstract: BACKGROUND
  Percutaneous nephrolithotomy is generally considered a safe option for the management of large complex or infectious upper urinary tract calculi. Biliary tract injury is a rare and potentially serious complication of percutaneous nephrolithotomy that can even lead to mortality, especially in cases where biliary peritonitis develops. All reported cases of biliary tract injury have been managed by either open or laparoscopic cholecystectomy.
  
  
  METHODS
  Herein for the first time, we report a 39-year old woman with biliary tract injury following percutaneous nephrolithotomy who was managed less invasively by insertion of a percutaneous cholecystostomy tube. The patient was discharged home shortly thereafter, and the tube was later removed at a follow up visit after a normal cholangiogram.
  
  
  CONCLUSIONS
  Biliary tract injury is a rare and potentially serious complication of percutaneous nephrolithotomy that can even lead to mortality. If a biliary tract injury is suspected during percutaneous renal procedures, diverting the bile away from the leak may resolve the problem without the need for a cholecystectomy. Ideally this can be done with ERCP and a stent, but in cases where this is not technically feasible; a percutaneous cholecystostomy can be successful at accomplishing the same result.
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Ata A
authors.initials: AA
authors.lastname: Rahnemai-Azar
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Rahnemaiazar
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Rozhin
authors.initials: R
authors.lastname: Naghshizadian
authors.affiliation: Department of Urology, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Jacob H
authors.initials: JH
authors.lastname: Cohen
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Iman
authors.initials: I
authors.lastname: Naghshizadian
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Brian F
authors.initials: BF
authors.lastname: Gilchrist
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Farkas
keywords: Biliary Tract; Cholecystostomy Tube; Injury; Minimally Invasive; Percutaneous Nephrolithotomy