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Case Reports
. 2021 Oct 27:11:55.
doi: 10.25259/JCIS_179_2021. eCollection 2021.

Percutaneous Transhepatic Holmium Laser Lithotripsy for Giant Biliary Stones

Nguyen Thai Binh  1   2 , Le Viet Dung  1 , Thieu-Thi Tra My  2 , Nguyen Minh Duc  2   3   4
Affiliations
Case Reports

Percutaneous Transhepatic Holmium Laser Lithotripsy for Giant Biliary Stones

Nguyen Thai Binh et al. J Clin Imaging Sci. .

Abstract

This case report describes a young female patient with a history of surgery to treat choledochal cyst since childhood who was admitted to our hospital with cholangitis. An imaging examination revealed giant stones that almost completely filled the intrahepatic biliary tract. The patient underwent percutaneous transhepatic lithotripsy using a holmium laser. After the lithotripsy, cholangiography showed no residual stones. The patient displayed clinical improvement and was discharged after 14 days in the hospital. This case serves as a reminder of gallstone complications that can occur subsequent to choledochal cyst surgery with biliary-enteric anastomosis and emphasizes many outstanding advantages of percutaneous transhepatic lithotripsy compared with classical surgery.

Keywords: Biliary stone; Choledochal cyst; Hepatolithiasis; Holmium laser; Percutaneous transhepatic lithotripsy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
A 30-year-old woman with symptoms of the right upper quadrant pain and fever. The diagnosis was cholangitis due to recurrent biliary stones and postsurgical choledochal cyst. Coronal T2-weighted images show a large biliary stone (arrow) (a) and some small biliary stones (arrow) (b). Axial T2-weighted images show a large biliary stone (arrow) (c) and some small biliary stones (arrow) (d) which frame huge dilations of the intrahepatic biliary ducts.
Figure 2:
Figure 2:
A 30-year-old woman with symptoms of the right upper quadrant pain and fever. The diagnosis was cholangitis due to recurrent biliary stones and postsurgical choledochal cyst. Single-shot digital subtraction angiography before lithotripsy reveals a giant hepatolithiasis. The patient underwent hepaticojejunostomy during a prior choledochal cyst surgery.
Figure 3:
Figure 3:
A 30-year-old woman with symptoms of the right upper quadrant pain and fever. The diagnosis was cholangitis due to recurrent biliary stones and postsurgical choledochal cyst. Image of cholangioscopy before (a) and after (b) lithotripsy (arrow in a: Biliary stone).
Figure 4:
Figure 4:
A 30-year-old woman with symptoms of the right upper quadrant pain and fever. The diagnosis was cholangitis due to recurrent biliary stones and postsurgical choledochal cyst. Single-shot digital subtraction angiography after lithotripsy confirmed the disappearance of the hepatolithiasis.
See this image and copyright information in PMC

References

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