Abstract
AbstractReoperation for removal of retained bile duct stones after cholecystectomy and common duct exploration can now be avoided by the technique of nonoperative instrument extraction of stones through the sinus tract from the indwelling T tube. In our institution, 380 patients underwent this new procedure of nonoperative percutaneous stone extraction from the biliary tract during the past 7 years. The extraction was accomplished in ambulatory patients under fluoroscopic control. It carried a success rate of 95% and only 5% of the patients required a second operation for stone removal. There was a complication rate of about 5%, and there were no bile duct perforations or mortality. When compared to other therapeutic methods for removing retained stones, such as reoperation, choledochoscopic instrumentation, and attempts at chemical stone dissolution, the nonoperative percutaneous method appears to be the procedure of choice. The nonoperative technique is now practiced in at least 100 institutions in the United States, and successful extractions have also been reported from other countries.
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