RSS-Feed abonnieren
DOI: 10.1055/s-1999-40
Georg Thieme Verlag Stuttgart · New York
Percutaneous Choledochoscopic Treatment of Intrahepatic Stones, Including Management of Associated Biliary Stenoses
Publikationsverlauf
Publikationsdatum:
31. Dezember 1999 (online)
![](https://www.thieme-connect.de/media/endoscopy/199906/lookinside/thumbnails/10.1055-s-1999-40-1.jpg)
Introduction
Percutaneous choledochoscopy was introduced as a method of removing intrahepatic stones in 1981 [1]. Percutaneous lithotomy using percutaneous transhepatic cholangioscopy (PTCS) has become one of the most important nonsurgical forms of treatment for hepatolithiasis. Although some authors [2] [3] have reported that this procedure is effective and safe, biliary strictures associated with retained and recurrent stones have also been described. The aim of the present study was to examine the relationship between the presence of strictures and the results of this form of treatment, such as the number of PTCS sessions required and the rate of stone recurrence. In addition, the efficacy, limitations, and risks of choledochoscopic lithotomy as a first-choice procedure were reviewed in an unselected series. A new approach to the management of biliary strictures associated with hepatolithiasis is also described here.
References
- 1 Nimura Y, Hayakawa N, Toyoda S, et al. Percutaneous transhepatic cholangioscopy [in Japanese with English abstract]. Stomach Intestine. 1981; 16 681-689
- 2 Yer YH, Huang MH, Yang JC, et al. Percutaneous transhepatic cholangioscopy and lithotripsy in the treatment of intrahepatic stones: a study with 5-year follow-up. Gastrointest Endosc. 1995; 42 13-18
- 3 Jan YY, Chen MF. Percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis: long-term results. Gastrointest Endosc. 1995; 42 1-5
- 4 Maetani I, Hoshi H, Ohashi S, et al. Cholangioscopic extraction of intrahepatic stones associated with biliary strictures using a rendezvous technique. Endoscopy. 1993; 25 303-306
- 5 Lee Y, Lee BH, Park JH, Suh CH. Balloon dilatation of intrahepatic biliary strictures for percutaneous extraction of residual intrahepatic stones. Cardiovasc Intervent Radiol. 1991; 14 102-105
- 6 Jan YY, Chen MF, Hung CF. Balloon dilatation of intrahepatic duct and biliary-enteric anastomosis strictures: long-term results. Int Surg. 1994; 79 103-105
- 7 Yamakawa T. Percutaneous cholangioscopy for management of retained biliary tract stones and intrahepatic stones. Endoscopy. 1989; 21 333-337
- 8 Jeng KS, Yang FS, Chiang HJ, Ohta I. Bile duct stents in the management of hepatolithiasis with long-segment intrahepatic biliary strictures. Br J Surg. 1992; 79 633-636
- 9 Jeng KS, Ohta I, Yang FS. Reappraisal of the systemic management of complicated hepatolithiasis with bilateral intrahepatic biliary strictures. Arch Surg. 1996; 131 141-147
- 10 Bonnel DH, Liguory CE, Cornud FE, Lefebvre JFP. Common bile duct and intrahepatic stones: results of transhepatic electrohydraulic lithotripsy in 50 patients. Radiology. 1991; 180 345-348
I. MaetaniM.D.
Third Dept. of Internal Medicine
Toho Unversity Ohashi Hospital
2-17-6 Ohashi Meguro-ku
Tokyo 153-8515
Japan
Telefon: + 81-3-3468-1269
eMail: maet@oha.toho-u.ac.jp