Percutaneous management of residual bile duct stones through T-tube tract after cholecystectomy: A retrospective analysis of 89 patients.

Abstract

The purpose of this study was to analyze the outcome of percutaneous management of residual common bile duct (CBD) stones in patients with surgically inserted T-tube in CBD after cholecystectomy. Between April 2001 and August 2015, 89 patients (52 women, 37 men) with a mean age of 55.7years±18 (SD) (range, 22-88years) underwent percutaneous sphincteroplasty and stone expulsion into the duodenum with a Fogarty balloon catheter through the T-tube tract for residual CBD stones. All patients had previously undergone open cholecystectomy with CBD exploration and T-tube insertion 7 to 60days (mean, 14.4days) before the procedure. Results of the procedure and complications were evaluated by a review of clinical notes, imaging and laboratory findings. The procedure was successful in 87/89 patients (97.7%). Complete CBD clearance was achieved in a first session in 86 patients (96.6%). One patient (1.1%) needed a second session. The procedure was unsuccessful in 2 patients (2.2%) due to inappropriate position of T-tube and stone impaction into the cystic duct remnant. Two complications (2.2%) including intra-abdominal bile collection and distal CBD stricture were observed after the procedure. Percutaneous CBD expulsion into the duodenum through the T-tube tract is a non-traumatic, effective and safe method for the treatment of residual CBD stones in patients who had cholecystectomy and T-tube insertion.