A Series of Interesting Radiographs from Dr. Yakshe's Experience

Percutaneous Choledochoscopy and Lithotripsy
This ninety two year old lady with severe aortic stenosis had recurrent biliary type pain and elevation of liver enzymes. Abdominal ultrasound showed a dilated biliary system. Routine ERCP was not possible because of prior surgery (Roux-en-Y). In collaboration with Interventional Radiology and Anesthesiology, we punctured into her bile duct through the liver and identified a large stone (note large filling defect). We then enlarged the tract, inserted a small scope to look inside the duct and brake up the stone using a technique called electrohydraulic lithotripsy and remove it from the bile duct. All this was done under conscious sedation under careful monitoring in the operating room.