Abstract
Percutaneous transhepatic cholangioscopic lithotomy (PTCSL) is effective, but we ofen took time on removing fragments of stones from the common bile duct. Then, we attempted to perform PTCSL with papillary balloon dilation in 10 cases. We slowly dilated the papilla under X ray observation with balloon, 8 mm in diameter. We destroyed the stones to fragments using electro -hydraulic lithotriptor under percutaneous transhepatic cholangioscopic observation, and removed fragments of stones to duodenum with the tip of scope. Complete clearance from the duct was obtained in all cases. In 7 cases of 10 cases, we could perform complete removal of stones by only one examination, without any other instruments. But complications, such as mild pancreatitis and hvperamvlasemia, occurred in 2 cases. Then, 4 to 7 days before PTCSL, we attempted to perform papillary balloon pre-dilation in other 10 cases. Complete clearance from the duct was obtained in all cases. Especially, in 9 cases of 10 cases, we could perform complete removal of stones by only one examination. And no complications occurred. In conclusion, PTCSL with papillary balloon pre-dilation was evaluted to be speedier, easier and safer than PTCSL with papillary balloon dilation.
