Removal of common bile duct stones by the combination of percutaneous balloon dilatation and extracorporeal shock-wave lithotripsy.

Endoscopic papillotomy may not be possible in patients who have previously undergone gastric surgery. We describe the successful treatment of such a patient with ultrasound-guided, percutaneous transhepatic biliary drainage, followed by balloon dilatation of the sphincter of Oddi and extracorporeal shock-wave lithotripsy. Combinations of new treatment forms may be necessary and effective when single forms of treatment fail.