Stone removal (Saline 50ml each time)
After CBD stone removal via lithotripsy, and the cholangiogram showed normal, residual CBD stones were detected by SpyGlass in the first round, if CBD not clean, sterile saline 50ml were intermittently irrigated into the CBD. After that, if bile duct clearance was not achieved, another 50ml saline will be irrigated into CBD again until the clear bile duct determined by SpyGlass.
Procedure: CBD stone removal via lithotripsy
Hold saline irrigation just after X-ray demonstrated no stone residue, a Spyglass explored.
Procedure: Saline 50ml
If not clean, intermittent saline irrigation 50ml, and Spyglass explored second time.
Procedure: Saline +50ml
If still have some stone fragments, intermittent saline irrigation another 50ml after the second Spyglass detection, Spyglass explored third time to evaluate stone clearance.