Three-dimensional visualization technology for guiding one-step percutaneous transhepatic cholangioscopic lithotripsy for the treatment of complex hepatolithiasis

Figure 1 Details of the liver reconstruction model. A: Iterative computed tomography images; B: The bile duct system involves the clearly visible hepatic bile duct segments, and the hepatolithiasis is labeled in yellow; C: Reconstruction of the location and size of the hepatolithiasis; D: A complete liver reconstruction model with intrahepatic bile duct stones.

Figure 2 Three-dimensional model combined with real-time B-ultrasonic navigation. A: Combination of three-dimensional reconstruction and B-ultrasound for guiding one-step percutaneous transhepatic cholangioscopic lithotripsy (PTCSL); B: Using the percutaneous transhepatic one-step biliary fistulation technique for one-step PTCSL.

Figure 3 One-step percutaneous transhepatic cholangioscopic lithotripsy using the percutaneous transhepatic one-step biliary fistulation technique. A: Ultrasound-guided puncture; B: Guidewire insertion; C: Fistula dilation D: Sheath insertion; E: Rigid choledochoscope exploration; F: Stone clearance; G: Stricture resolution using an electric knife.