Back to Search
Start Over
Cholecystostomy as an Exclusive Access to Remove Cystic, Common Hepatic, and Common Bile Duct Stones
- Source :
- AJR. American journal of roentgenology. 215(5)
- Publication Year :
- 2020
-
Abstract
- OBJECTIVE. The purpose of this article was to evaluate the feasibility and efficacy of percutaneous fluoroscopic-guided stone retrieval from the cystic duct and antegrade common bile duct (CBD) stone advancement into the duodenum exclusively through a cholecystostomy tube. MATERIALS AND METHODS. Twenty-one patients with acute cholecystitis and choledocholithiasis or an impacted cystic duct stone who underwent percutaneous cholecystostomy tube placement were retrospectively enrolled in this study. The patients had a contra-indication for cholecystectomy (17 patients because of comorbidities and one who declined surgery) or had failed endoscopic retrograde stone removal attempts (three patients). RESULTS. The 21 patients underwent subsequent percutaneous CBD (17 patients) and cystic duct (nine patients) stone removal on follow-up sessions through the percutaneous cholecystostomy track using moderate sedation. A total of 32 stone removal procedures were performed. Seventeen patients underwent balloon dilatation sphincterotomy, after which the CBD stones were pushed forward into the duodenum using a compliant balloon. Seven patients also had stone removal from the cystic duct by a stone retrieval basket. The primary technical success rate for removal of all CBD and cystic duct stones was 76%. The secondary technical success rate was 100%. The clinical success rate was 74%. All patients tolerated the procedures well without major complication. The clinical follow-up interval ranged from 2 to 2310 days (median, 30 days), with no incidence of postprocedural complications. CONCLUSION. Percutaneous transcholecystic common bile and cystic duct stone removal through an existing cholecystostomy access is a safe and effective procedure that is well tolerated.
- Subjects :
- Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
Cholecystitis, Acute
Gallstones
Balloon
Cystic Duct Stone
Bile Ducts, Extrahepatic
medicine
Humans
Radiology, Nuclear Medicine and imaging
Cholecystostomy
Aged
Retrospective Studies
Aged, 80 and over
Common bile duct
business.industry
Cystic Duct
General Medicine
Middle Aged
Surgery
medicine.anatomical_structure
Choledocholithiasis
Duodenum
Cystic duct
Feasibility Studies
Cholecystectomy
Female
business
Subjects
Details
- ISSN :
- 15463141
- Volume :
- 215
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- AJR. American journal of roentgenology
- Accession number :
- edsair.doi.dedup.....210715ddcb15044adb659b6bbdbbde1b