Percutaneous transhepatic cholangioscopy and lithotripsy for complicated hepatolithiasis

Hepatolithiasis, which is prevalent in Southeast Asia, presents a difficult management problem. Surgery was previously regarded as the mainstay of treatment, but it carries with it a higher risk for patients with recurrent stones or in poor surgical condition. In this study, percutaneous transhepatic cholangioscopy and lithotripsy were carried out in 15 patients and the complete clearance of stones was achieved in 13 patients (86%). Two patients had fever after their procedures, but recovered after conservative treatment. The 13 successfully treated patients remained well after a mean follow-up of 18 months. Percutaneous transhepatic cholangioscopy and lithotripsy are effective and safe methods of treatment for complicated hepatolithiasis.