To the Editor.—Recently, several articles have appeared in the literature concerning the complications of the Fogarty balloon catheter in the exploration of the common and hepatic ducts.1-3 We, also, have had the same experience of disrupting the smaller hepatic ducts and creating biliary lakes. As others have discovered, these lakes will disappear with time, but we feel that we have devised a way of continuing the use of the Fogarty catheter without complication.
The inherent variables common to all balloons are what cause the disruptions. These are due to the mode in which they are made by the dipping process that creates unequal thickness. Each time the balloon is opened, it requires a different pressure. The lack of graduation in size causes the balloon to open suddenly. Thus, it becomes difficult to ascertain the required opening pressure.
Our technique enables us to inflate the balloon slowly. At the
BUTSCH JL. A Technique for the Prevention of Hepatic Duct Disruption Caused by the Use of the Fogarty Biliary Catheter. Arch Surg. 1974;108(3):381. doi:10.1001/archsurg.1974.01350270111024