Removal of retained common bile duct stones with angiographic occlusion balloons.

Interventional biliary radiology has a well established role in the management of retained common bile duct stones [1-5]. In most cases, a Dormia stone basket is passed through a T-tube track to extract the retained calculi or to pass them into the duodenum. If the stones are large, it may be necessary to fragment them before they can be engaged in the basket and pulled through the T-tube track or pushed through the ampulla of Vater. When the T-tube track forms an acute angle with the common bile duct, it may be impossible to position the basket properly. In difficult cases such as these, we have used angiographic occlusion balloon catheters’ to extract the stones from peripheral ducts and/or then push them down through the common duct and the ampulla of Vater into the duodenum. We have used this technique in 16 patients with excellent clinical results and no complications.