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  • Title: Percutaneous transhepatic small-caliber choledochoscopic lithotomy: a safe and effective technique for percutaneous transhepatic common bile duct exploration in high-risk elderly patients.
    Author: Ogawa K, Ohkubo H, Abe W, Maekawa T.
    Journal: J Hepatobiliary Pancreat Surg; 2002; 9(2):213-7. PubMed ID: 12140609.
    Abstract:
    PURPOSE: Endoscopic bile duct clearance is now the treatment of first choice for bile duct stones, particularly in elderly or high-risk patients. The purpose of this study was to objectively assess the safety, efficiency, and ease of use of percutaneous transhepatic choledochoscopy, using a small-caliber choledochoscope with a facilitated insertion technique, in high-risk elderly patients with choledocholithiasis. METHODS: Sixty-five consecutive patients with common bile duct stones scheduled for percutaneous transhepatic choledochoscopic lithotomy were studied prospectively. Choledochoscopy was carried out with a simplified introducer system, using a 2.8-mm choledochoscope with electrohydraulic lithotripsy. RESULTS: The common bile duct was successfully accessed and the stones removed in all 65 patients. The average time for the entire procedure was 45 min. There were no serious procedure-related complications. CONCLUSIONS: Percutaneous transhepatic choledochoscopic lithotomy, using electrohydraulic lithotripsy, is an attractive alternative for patients with common bile duct stones when surgery or retrograde methods are not suitable.
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