Percutaneous transhepatic cholecystoscopy and biliary endoscopic lithotripsy.

We have been developing procedures for percutaneous transhepatic cholecystoscopy (PTCCS) through the sinus tract of percutaneous transhepatic cholecystostomy since 1981, and have used this method on 67 patients with gall bladder diseases. We also performed biliary endoscopic lithotripsy with PTCCS and percutaneous transhepatic cholangioscopy (PTCS) using a Nd-YAG laser or electrohydraulic shock wave lithotripter to non-operatively treat 83 patients with cholangiolithiasis, 11 with cholecystolithiasis, and four with cholecysto-choledocholithiasis. The present paper reports the PTCCS procedures and their usefulness for the precise diagnosis of early carcinoma of the gall bladder, and the usefulness and safety of biliary endoscopic lithotripsy techniques.