Percutaneous transhepatic holmium laser lithotripsy of a large common bile duct stone

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• 作者：Adam K. Deal ; MD^a ; ^{adamkdeal@gmail.com} ; Shashidhara Murthy ; MD^a ; Shaun Wason ; MD^b ; Harlan Vingan ; MD^c ; Michael Fabrizio ; MD^b
• 关键词：Holmium laser ; Percutaneous lithotripsy ; Interventional radiology ; Biliary intervention ; Choledocolithiasis
• 刊名：Radiology Case Reports
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：11
• 期：4
• 页码：361-364
• 全文大小：1323 K
• 卷排序：11

文摘

A 58-year-old woman presented with a 4 cm obstructing choledocolith within the proximal common bile duct. She had an extensive operative history resulting in common bile duct to jejunum anastomosis after cholecystectomy. Endoscopic retrograde cholangiopancreatography (ERCP) removal was unsuccessful, and surgical exploration was contraindicated due to multiple comorbidities. Interventional radiologist placement of bilateral transhepatic ureteral access sheaths allowed Urologist evaluation of the biliary tract by ureteroscope. Holmium laser lithotripsy was performed with successful fragmentation of the stone and clearance of the obstruction, without complication. The case is relevant to the growing literature on the management of refractory biliary stones after failed ERCP.