<b>Balloon Sphincteroplasty and Transpapillary Elimination of Bile Duct Stones:</b>10 Years' Experience

García-Vila, José H.; Redondo-Ibáñez, Marta; Díaz-Ramón, Carlos

doi:10.2214/ajr.182.6.1821451

Cited by 35 publications

(26 citation statements)

References 35 publications

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“…Percutaneous transhepatic removal of CBD stones is a minimally invasive alternative for surgical treatment. This approach is not commonly used for patients in whom ERCP treatment is not possible and only a few studies have reported the results of this procedure [17,18,19,20,21,22,23]. …”

Section: Introductionmentioning

confidence: 99%

Percutaneous Treatment of Common Bile Duct Stones: Results and Complications in 110 Consecutive Patients

et al. 2015

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Background/Aims: Choledocholithiasis is a common complication of cholecystolithiasis, occurring in 15-20% of patients who have gallbladder stones. Endoscopic retrograde cholangio-pancreatography is the standard treatment. When this is not possible or not feasible, percutaneous transhepatic stone removal is an alternative treatment. In this retrospective study, we analyze 110 patients who were treated with percutaneous transhepatic removal of Common Bile Duct (CBD) stones. Patients and Methods: Between March 1998 and September 2013 110 patients (61 men, 49 women; aged 14-96, mean age 69.7 years) with confirmed bile duct stones were included. PTC was done using ultrasound and fluoroscopy. Balloon dilatation of the papilla was done with 8-12 mm balloons. If stone size exceeded 10 mm, mechanical lithotripsy was performed. Stones were then removed by percutaneous extraction or evacuation into the duodenum. Results: In 104 patients (104/110; 94.5%) total stone clearance of the CBD was achieved. A total of 12 complications occurred (10.9%), graded with the Clavien-Dindo scale as IVa, IVb, and V, respectively; hypoxia requiring resuscitation, sepsis and death due to ongoing cholangiosepsis (n = 1, 4, 1). Minor complications I, II, and IIIa included: small liver abscess, pleural empyema, transient hemobilia and mild fever (n = 1, 1, 2, 2). Conclusion: Percutaneous removal of CBD stones is an effective alternative treatment, when endoscopic treatment is contra-indicated, fails or is not feasible. It is effective, has a low complication rate and using deep sedation potentially requires only a very limited number of treatment sessions.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Treatment of Common Bile Duct Stones: Results and Complications in 110 Consecutive Patients

et al. 2015

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“…Percutaneous antegrade expulsion of bile stones into the duodenum over a dilated papilla was initially described by Meranze et al [10], Muchart et al [11], and Gil et al [12] and then reported by others [2,13,14] in large series of patients. This technique is considered to be safe and effective: maintenance of the anatomic integrity and function of the sphincter is desirable, resulting in a great advantage compared with other treatment techniques, such as endoscopic papillotomy or surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The sheath can also be used to administer contrast material, prevent air bubbles, and avoid tract injury [2]. The access to the bile duct permits repetition of the expulsion maneuver as many times as necessary, and having the bile duct with external drainage in position for several days reduces the risk for manipulation-induced cholangitis by precluding sphincter spasm and providing an egress route for infected bile [2,14]. The presence of an internal-external biliary catheter after the procedure enables the option of repeated cholangiography, which may be necessary, for example, if the biliary function deteriorates.…”

Section: Discussionmentioning

confidence: 99%

Innovative percutaneous antegrade clearance of intrahepatic and extrahepatic biliary stones with the use of a hysterosalpingography catheter

Patrone¹,

Parthipun²,

Diamantopoulos³

et al. 2015

European Journal of Gastroenterology &Amp; Hepatology

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“…Different interventional techniques have been previously reported to perform percutaneous transhepatic removal of bile duct stones by using a Fogarty balloon catheter [Ozcan et al 2012] or occlusion balloon [García-Vila et al 2004].…”

Section: Discussionmentioning

confidence: 99%

Combined radiological-endoscopic management of difficult bile duct stones: 18-year single center experience

Cannavale

Bezzi

Cereatti

et al. 2015

Therap Adv Gastroenterol

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Objectives: Clinical evidence regarding radiological-endoscopic management of intrahepatic bile duct stones is currently lacking. Our aim is to report our 18-year experience in combined radiological-endoscopic management of intrahepatic difficult bile duct stones. Methods: From June 1994 to June 2012, 299 symptomatic patients with difficult bile duct stones were admitted to our institution. Percutaneous transhepatic cholangiography (PTC)/ biliary drainage/s was performed, dilating the PTC track to 10 or 16 French within 3-7 days. Afterward we carried out percutaneous transhepatic cholangioscopy (PTCS) with electrohydraulic lithotripsy (EHL) and/or interventional radiology techniques. Follow up was made with clinical/laboratory tests and ultrasound (US). We retrospectively analyzed our radiological-endoscopic approach and reported our technical and clinical outcomes. Results: Complete stone clearance was achieved in 298 patients after a maximum of 4 consecutive sessions. Most patients (64.6%) were treated with PTCS/EHL alone, while the remaining with radiological techniques alone (26%) or a combination of both techniques (13.3%). Recurrence of stones occurred in 45 cases (15%, Tsunoda class III and class IV) within 2 years and were successfully retreated. Major adverse events were: 5 (1.6%) cases of massive bleeding that required embolisation, 2 (0.66%) perforations of the common bile duct and 31 cases (10.3%) of acute cholangitis managed with medical therapy or intervention. Conclusion: After 18 years of experience we demonstrated that our combined radiologicalendoscopic approach to 'difficult bile duct stones' may result in both immediate and long-term clearance of stones with a low rate of adverse events.

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Balloon Sphincteroplasty and Transpapillary Elimination of Bile Duct Stones:10 Years' Experience

Abstract: Balloon sphincteroplasty and transpapillary elimination of bile duct stones is an effective and safe technique.

Cited by 35 publications

References 35 publications

Percutaneous Treatment of Common Bile Duct Stones: Results and Complications in 110 Consecutive Patients

Percutaneous Treatment of Common Bile Duct Stones: Results and Complications in 110 Consecutive Patients

Innovative percutaneous antegrade clearance of intrahepatic and extrahepatic biliary stones with the use of a hysterosalpingography catheter

Combined radiological-endoscopic management of difficult bile duct stones: 18-year single center experience

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