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December 13, 1976

Postoperative Choledochoscopy via the T-Tube Tract

Author Affiliations

From the Departments of Surgery (Drs Moss, Dedman, and Oliver), Radiology (Dr Whelan), and Medicine (Dr Powell), and the Section on Respiratory and Environmental Disease (Dr Powell), University of Louisville, Louisville, and St Anthony's Hospital, Louisville (Dr Whelan).

JAMA. 1976;236(24):2781-2782. doi:10.1001/jama.1976.03270250049029

MAJOR advances have been made in the postoperative management of retained biliary stones during the last decade.1,2 The contributions of Lamis et al, Mazzariello, Mondet, and others3-6 have provided the foundation for percutaneous extraction of retained calculi and have resulted in a safe, effective means of avoiding complicated reoperative biliary procedures.

The technique consists of passing a basket catheter into the common duct via the T-tube tract, grasping the stone under fluoroscopic control, and extracting the calculus through the fistulous tract. With experience and technical innovations in the design of basket catheters, percutaneous extraction is successful in 70% to 90% of cases and is associated with a very low morbidity.7,8 The failures of percutaneous extraction are often related to technical difficulties, the selection of a T tube, angulation in the T-tube tract, and the presence of multiple stones.9

A solution to these problems would further reduce