A novel technique of percutaneous stone extraction in choledocholithiasis after cholecystostomy

Background/Aims: To evaluate the technical feasibility and clinical efficacy of percutaneous common bile duct stone extraction via cystic duct after percutaneous cholecystostomy. Methodology: Twenty-five consecutive patients with choledocholithiasis underwent percutaneous stone extraction under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance via cystic duct after percutaneous trans-hepatic cholecystostomy. Results: Common bile duct stones were successfully removed in 22 of the 25 patients (88%) by this new technique. The causes of failure in three patients were bile leakage, hematoma of the gallbladder and failure of cystic duct cannulation. Cystic duct injury during this procedure did not occur and there was no post-procedure mortality. The mean period of the indwelling catheter was 8.7±4.6 days and the mean duration of hospitalization was 13.4±5.9days. Conclusions: Percutaneous common bile duct stone extraction via the cystic duct through percutaneous cholecystostomy route is effective and feasible for treating choledocholithiasis.