Percutaneous Transhepatic Cholangioscopy and Lithotripsy for Intrahepatic Biliary Stones and Sclerosing Cholangitis Secondary to Kasai Procedure for Biliary Atresia: A Case Report

The primary therapy for biliary atresia is a surgical hepatic portoenterostomy, known as Kasai procedure, which has been shown to reduce mortality. Patients that undergo this procedure often develop complications such as ascending cholangitis and biliary cirrhosis. In case of recurrent cholangitis, surgical revision and percutaneous biliary drainage are the most used techniques, while in rare cases endoscopic retrograde cholangiopan­creatography (ERCP) has been used. Here we report a case of a patient with intrahepatic lithiasis and secondary sclerosing cholangitis after Kasai procedure, successfully treated with percutaneous transhepatic cholangioscopy (PTCS)-assisted lithotripsy.