Percutaneous Treatment of Biliary Stone Disease
A variety of percutaneous interventions exist for the treatment of biliary stones. The options for percutaneous access to the biliary system include direct puncture of the gallbladder or transhepatic puncture of the intrahepatic biliary ducts. In patients with prior biliary surgery, percutaneous access can be achieved through a biliary drain or T-tube placed at time of operation. In cases of more complex biliary surgery, such as hepaticojejunostomy, access may be obtained by puncture of the surgically created limb or loop of bowel. The percutaneous route is valuable in cases where surgical approaches are felt to be high risk due to medical comorbidities or when conventional endoscopic access to the biliary tree is not feasible for anatomic reasons.
KeywordsPercutaneous Transhepatic Biliary stone Cholelithiasis Choledocholithiasis Cholangioscopy Cholecystoscopy Cholecystolithotomy
PTC technique for placement of an internal-external biliary drain (MP4 352514 kb)
Flexible choledochoscopy through percutaneous cholecystostomy sheath for gallstone extraction from gallbladder. Safety wire is visible in the gallbladder lumen. Holmium laser used to fragment large stones for basket extraction (MP4 63939 kb)