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Percutaneous transcystic cholangioscopy-guided electrohydraulic lithotripsy in a patient with altered surgical anatomy - 1.º Prémio (Vídeo)
Percutaneous transcystic cholangioscopy-guided electrohydraulic lithotripsy in a patient with altered surgical anatomy - 1.º Prémio (Vídeo)
Joel Ferreira-Silva, Eduardo Rodrigues-Pinto, Pedro Pereira, Guilherme Macedo
Centro Hospitalar Universitário de São João
A 68-year-old man with history of distal gastrectomy underwent urgent cholecystectomy due to acute cholecystitis. Intraoperative choledochoscopy showed an unremovable common bile duct (CBD) stone; a transcystic nelaton tube was placed, with subsequent accidental displacement. As percutaneous biliary drainage persisted, percutaneous transcystic cholangioscopy-guided electrohydraulic lithotripsy was performed. Contrast instilled on percutaneous access confirmed persistence of the tract; guidewire passage into the CBD was achieved with contrast and single-operator cholangioscope assistance; cholangioscope passage was possible after dilatation of the proximal tract, with stone visualization in the distal CBD. Electrohydraulic lithotripsy was performed with stone pulverization. Patient remains well one month later.