Percutaneous stone removal using cobra-shaped sheath and cholangioscopy for multiple hepatolithiasis with choledochoduodenal anastomotic stenosis

Fumio Chikamori, MD; Shigeto Shimizu, MD; Satoshi Ito, MD; Michiyo Okazaki, MD; Nobuyuki Tanida, MD; Niranjan Sharma, MD

Radiology Case Reports (Jun 2022)

Percutaneous stone removal using cobra-shaped sheath and cholangioscopy for multiple hepatolithiasis with choledochoduodenal anastomotic stenosis

Fumio Chikamori, MD,
Shigeto Shimizu, MD,
Satoshi Ito, MD,
Michiyo Okazaki, MD,
Nobuyuki Tanida, MD,
Niranjan Sharma, MD

Affiliations

Fumio Chikamori, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562, Japan; Corresponding author.
Shigeto Shimizu, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562, Japan
Satoshi Ito, MD: Department of Radiology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562, Japan
Michiyo Okazaki, MD: Department of Gastroenterology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562, Japan
Nobuyuki Tanida, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562, Japan
Niranjan Sharma, MD: Adv Train Gastroint & Organ Transp Surgery, 12 Scotland Street Dunedin, 9016, New Zealand

Journal volume & issue: Vol. 17, no. 6
pp. 1890 – 1896

Abstract

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Management of multiple hepatolithiasis with choledochoenteral anastomotic stenosis remains difficult and time-consuming. We report a case of a 77-year-old man with severe right hypochondoralgia, treated with percutaneous transhepatic balloon dilatation of choledocoduodenal anastomotic stenosis and percutaneous stone removal using 8Fr. cobra-shaped sheath and cholangioscopy. Hilar hepatic stones were pushed out into the duodenum through the dilated anastomosis using 5Fr. balloon catheter covered with the sheath and cholangioscopy. For stones located in the left, right anterior and aberrant right posterior hepatic ducts, a guidewire and a removal balloon catheter were inserted by using the cobra-shaped sheath. Stones pulled from the intrahepatic bile ducts to the common hepatic duct were pushed out into the duodenum. Clearance of intrahepatic bile duct stones was confirmed by balloon-occluded cholangiography using the cobra-shaped sheath and 6Fr. balloon catheter. The use of cobra-shaped sheath improved percutaneous stone removal, but the procedure needs further improvement.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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