Percutaneous transhepatic antegrade bile duct stone removal in patients with surgically altered anatomy: A report of three cases

Abstract

It is challenging to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy. We retrospectively investigated the clinical outcomes of three patients with cholangitis, who had surgically altered anatomies and who underwent percutaneous transhepatic antegrade intrahepatic and common bile duct stone removal at Showa University Hospital between April 2014 and December 2015. All patients received percutaneous transhepatic biliary drainage (PTBD) and antibiotic therapy for cholangitis. After cholangitis was successfully treated, we performed percutaneous transhepatic antegrade treatment for removing stones from the bile duct. We succeeded in removing the stones completely without any adverse events. Percutaneous transhepatic antegrade bile duct stone removal may be feasible in patients with cholangitis, who have surgically altered anatomy.