Cryoprecipitate coagulum for removal of "inaccessible" biliary stones

Abstract AR

Exploration of the common bile duct is sometimes a challenge to the surgeon, particularly for inacces¬sible multiple biliary stones.

Retained calculi may result (in 5-25% of cases)1'3 even after careful common bile duct exploration combined with choledochoscopy.

The use of modified tenacious coagulum to entrap and extract those calculi is now an established technique.

4'5 The coagulum for choledocholithotomy is prepared by mixing 20 parts of cryoprecipitate with one part of 10 % calcium chloride solution without thrombin.

The technique is safe, simple, nontraumatic, and very effective in extraction of the stones.