A 10 year single centre experience of percutaneous and endoscopic extraction of bile duct stones with T tube in situ.

A non-randomised single centre study of 226 consecutive patients referred over 10 years with retained common bile duct stones and a T tube in situ or a cholecystostomy tube are reported. Percutaneous extraction was attempted in 204 and endoscopic extraction in 68 patients. Percutaneous clearance was achieved in 158 (77.5%) patients and endoscopic clearance in 52 (76.5%) patients. Six of 153 (3.9%) patients followed after percutaneous treatment suffered major complications (pancreatitis, cholangitis, or tract perforation). Three of 67 (44%) patients followed after endoscopic treatment suffered major complications (pancreatitis, cholangitis, or bleeding). When the initial method of treatment failed, the alternative was used, resulting in an overall success rate of bile duct clearance of 94.3%. It is concluded that percutaneous and endoscopic methods of bile duct clearance in patients with a T tube in situ are equally effective, carrying similar complication rates. This study has helped to clarify the indications and efficacy of these alternative treatments.

[1]  StephenD. Williams,et al.  ENDOSCOPIC SPHINCTEROTOMY IN 1000 CONSECUTIVE PATIENTS , 1989, The Lancet.

[2]  P. Cotton,et al.  Additional endoscopic procedures instead of urgent surgery for retained common bile duct stones. , 1989, Gut.

[3]  R. Chapman,et al.  Early postoperative endoscopic sphincterotomy for retained biliary stones. , 1988, Annals of the Royal College of Surgeons of England.

[4]  D. Martin,et al.  Endoscopic removal of retained stones after biliary surgery , 1988, The British journal of surgery.

[5]  W. Murray,et al.  Choledocholithiasis--in vivo stone dissolution using methyl tertiary butyl ether (MTBE). , 1988, Gut.

[6]  F. D. Di Padova,et al.  Methyl tert-butyl ether fails to dissolve retained radiolucent common bile duct stones. , 1986, Gastroenterology.

[7]  A. Moossa,et al.  Chemical treatment of stones in the biliary tree , 1986, The British journal of surgery.

[8]  J. Neoptolemos,et al.  Endoscopic sphincterotomy for retained common bile duct stones in patients with T‐tube in situ in the early postoperative period , 1986, The British journal of surgery.

[9]  U. Leuschner.  Endoscopic therapy of biliary calculi. , 1986, Clinics in gastroenterology.

[10]  A. Hofmann,et al.  Intraductal mono-octanoin for the direct dissolution of bile duct stones: experience in 343 patients. , 1986, Gut.

[11]  C. J. Simpson,et al.  Early endoscopic sphincterotomy for retained common bile duct stones. , 1985, Journal of the Royal College of Surgeons of Edinburgh.

[12]  A. Axon,et al.  Medium term complications of endoscopic biliary sphincterotomy. , 1985, Gut.

[13]  Mason Rr.  Percutaneous extraction of retained gallstones. , 1985 .

[14]  J. Neoptolemos,et al.  Successes, failures, early complications and their management following endoscopic sphincterotomy: Results in 394 consecutive patients from a single centre , 1985, The British journal of surgery.

[15]  R. Mason.  Percutaneous extraction of retained gallstones. , 1985, Clinics in gastroenterology.

[16]  H. Beaton,et al.  Early endoscopic sphincterotomy for extraction of residual stones of the common bile duct. , 1984, Surgery, gynecology & obstetrics.

[17]  P. Cotton.  Endoscopic management of bile duct stones; (apples and oranges). , 1984, Gut.

[18]  K. Hübner,et al.  Biochemical and morphological investigations of the toxicity of a Capmul preparation and a bile salt-EDTA solution in patients with bile duct stones. , 1984, The American journal of gastroenterology.

[19]  N. Lygidakis.  Surgical approaches to recurrent choledocholithiasis. Choledochoduodenostomy versus T-tube drainage after choledochotomy. , 1983, American journal of surgery.

[20]  J. Wong,et al.  Extraperitoneal Sphincteroplasty for Residual Stones An Update , 1982, Annals of surgery.

[21]  D. Birkett,et al.  Postoperative fiberoptic choledochoscopy. , 1981, Annals of surgery.

[22]  R. C. Davis,et al.  Modification of a bronchoscope for percutaneous choledochoscopy. , 1981, Gastrointestinal endoscopy.

[23]  N. Soehendra,et al.  Early post-operative endoscopy after biliary tract surgery. , 1981, Endoscopy.

[24]  A. Crummy,et al.  Retained biliary tract stones. Nonsurgical treatment with capmul 8210, a new cholesterol gallstone dissolution agent. , 1981, Archives of surgery.

[25]  J. Caprini,et al.  Results of nonsurgical treatment of retained biliary calculi. , 1980, Surgery, gynecology & obstetrics.

[26]  H. Burhenne.  Garland lecture. Percutaneous extraction of retained biliary tract stones: 661 patients. , 1980, AJR. American journal of roentgenology.

[27]  D. Birkett,et al.  Choledochoscopic removal of retained stones via a T-tube tract. , 1980, American journal of surgery.

[28]  C. Mcsherry,et al.  The Incidence and Causes of Death Following Surgery for Nonmalignant Biliary Tract Disease , 1980, Annals of surgery.

[29]  P. Cotton,et al.  Combined endoscopic and percutaneous trans-cystic approach to a retained common duct stone. , 1980, The British journal of radiology.

[30]  J. Whelan,et al.  Postoperative choledochoscopy through the T-tube tract. , 1980, Surgery, gynecology & obstetrics.

[31]  R. Mason.  Percutaneous extraction of retained gallstones via the T-tube track-British experience of 131 cases. , 1980, Clinical radiology.

[32]  P. H. Powell,et al.  Exploration of the common bile duct: A comparative study , 1979, The British journal of surgery.

[33]  M. H. Fainsinger,et al.  A death following complications of roentgenologic nonoperative manipulation of common bile duct calculi. , 1977, Radiology.

[34]  R. Powell,et al.  Postoperative choledochoscopy via the T-tube tract. , 1976, JAMA.

[35]  H. Burhenne.  The technique of biliary duct stone extraction. Experience with 126 cases. , 1974, Radiology.

[36]  F. Glenn.  Retained Calculi within the Biliary Ductal System , 1974, Annals of surgery.

[37]  W. Longmire,et al.  Problems of retained and recurrent common bile duct stones. , 1957, Journal of the American Medical Association.

[38]  F. Glenn,et al.  The age factor in the mortality rate of patients undergoing surgery of the biliary tract. , 1955, Surgery, gynecology & obstetrics.