Abstract
Hepatolithiasis is a complex disease with a high recurrence rate, and may lead to recurrent cholangitis, biliary cirrhosis and cholangiocarcinoma. Traditional surgery to treat hepatolithiasis has its shortcomings such as causing injury and incomplete removal of stones. Percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) is a safe and reliable method for hepatolithias causing minimal trauma, a fast recovery and a small incision. Cholangioscopes and ureteroscope inability to reach the target bile duct is usually due to the difficult acute angle of bile duct caused by biliary stricture and biliary fibrosis. We used PTCSL in conjunction with interventional radiology (IR) techniques and Endoscopic retrograde cholangiopancreatography (ERCP) accessories for this situation and achieved an effective stone clearance.