Percutaneous transhepatic choledochoscopic electrohydraulic lithotripsy (PTSC-EHL) of a common bile duct stone complicating a postsurgical biliary anastomosis

Aims Until recently, patients with common bile duct stones in a post-surgical anatomy (i.e. Billroth II or Roux-en-Y procedures) had limited options in case the classical endoscopic approach failed. The percutaneous approach, by conventional interventional radiology techniques, was not able to adequately address large stones in the bile ducts. The development of a new type of cholangioscope (the SpyGlass Discovery), dedicated for percutaneous treatment of intraductal disease, has dramatically improved the management of these difficult cases.