Percutaneous biliary stone clearance: is there still a need? A 10-year single-centre experience. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Kilic, Y.; Graham, A.; Tait, N.P.; Spalding, D.; Vlavianos, P.; Jiao, L.R.; Alsafi, A.
• Is Part Of: Clinical radiology. Volume 77:Issue 2(2022)
• Page Start: 130
• Page End: 135
• Publication Date: 2022-02
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2021.10.015
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To evaluate the safety and efficacy of percutaneous biliary stone clearance in a single hepatopancreaticobiliary (HPB) centre. MATERIALS AND METHODS: All patients who underwent percutaneous biliary stone clearance between 2010 and 2020 at a HPB centre were identified from the radiology information system. Their demographic data, presentation, previous surgery, number/size of biliary calculi, success and complications were collected from patient records. Unpaired student's t -test was used to compare numerical variables and the Chi-square test was used to compare categorical data. RESULTS: Sixty-eight patients aged between 58.5–91.1 years underwent the procedure, and 42.6% (29/68) had the procedure due to surgically altered anatomy precluding endoscopic retrograde cholangiopancreatography (ERCP). The most common presentation was cholangitis (62%). The success rate of percutaneous stone clearance was 92.7%. The average number of calculi was two (range 1–12). Of the patients included, 4.4% developed pancreatitis, 4.4% developed cholangitis, and 1.5% had hepatic artery branch pseudoaneurysm successfully treated with transarterial embolisation. There was no significant difference in success or complication rates between the different access sites (right lobe, left lobe, roux-loop, T-tube, p= 0.7767). CONCLUSION: Percutaneous biliary stone clearance is safe and effective and will continue to play an important role where ERCP fails or is impossible due surgically altered anatomy. Highlights: Biliary calculi can be effectively treated percutaneously when ERCP is not possible. The technique plays an important role in patients with surgically altered GI anatomy. Percutaneous cholangioscopy & lithotripsy may facilitate treatment of larger calculi.