Percutaneous transhepatic extraction and balloon dilation for simultaneous gallbladder stones and common bile duct stones: A novel technique

Figure 1 Puncture of the bile duct, and cholangiography showing the number, size, and location of simultaneous gallbladder and common bile duct stones.

Figure 2 Sequential dilation of the sphincter of Oddi with an 8 mm × 60 mm and a 14 mm × 40 mm balloon.

Figure 3 Empty balloon was then withdrawn above the stones, inflated, and used to push the stones into the duodenum through the sphincter of Oddi. A: The empty balloon was withdrawn above the common bile duct stones (white arrow) and then re-inflated. B: The common bile duct stones (white arrow) were pushed into the duodenum through the dilated sphincter of Oddi.

Figure 4 Percutaneous clearance of gallbladder stones. A: Sequential introduction of a guidewire and 4-Fr single-angle catheter into the gallbladder through the cystic duct, and cholangiography showing the number, size, and location of the gallbladder stones (white arrow); B: Capture of stones in a metallic basket; C: Aspiration of sandy stones out of the body through a guide catheter.