2007 Volume 49 Issue 1 Pages 60-69
Knacks for doing PTCS safely and adequately were outlined. As for lithotomy, it was used in patients with hepatolithiasis and those with CBD stones which is difficult to be removed by transpapillary procedures. In terms of treatment for hepatolithiasis, choice of appropriate route for lithotomy and optimal management of stenosis offers a high success rate. On the other hand, PTCS was also performed to determine mucosal spreading of the bile duct cancer (especially papillary type or protruded type) and to do ablative treatment for unresectable bile duct cancer. Laser or microwave is used for ablative therapy. It is very important to avoid over cauterization in order to reduce the risk of major complication such as perforation or bleeding.
