[Percutaneous removal of residual calculi of the bile ducts by T-drainage tract].

Percutaneous instrumentation under fluoroscopic control via the T tube tract is a minimally invasive technique to remove retained bile duct stones after cholecystectomy. 23 of 25 patients were treated successfully with this method. Two patients needed either percutaneous transhepatic stone-removal or repeat surgery because his residual calculus could neither be removed percutaneously nor endoscopically. In standard situations, the calculi were removed quickly and easily under outpatient conditions. Impacted and large calculi had to be mobilized and fragmented prior to their removal. One patient developed fever, another a mild, transient pancreatitis, no serious complications were observed. In large series, the success rate is 86-95%, the complication rate 3-5%, and the mortality rate 0-0.1%. A relative drawback of the percutaneous technique is the waiting period of approximately 4 weeks which is required for tract maturation. However, this inconvenience is acceptable if we consider that the risk of the percutaneous procedure is less than with endoscopic retrograde sphincterotomy. Therefore, we still favour a primary percutaneous radiologic approach to remove retained bile duct stones.