ABSTRACT
Objective To summarize the experience of ultrasound-guided percutaneous nephrostomy during percutaneous nephrolithotomy(PCNL) under B-ultrasound guidance. Methods A ultrasound-guided percutaneous nephrostomy was performed in 43 cases by using a 18-gauge needle.Then the percutaneous puncture was expanded for establishing a working tunnel. Under nephroscope,stone fragmentation was completed in the renal pelvis and the upper segment of the ureter.Results The success rate of percutaneous puncture was 100%.Of the 43 cases,the percutaneous working tunnel was successfully established in 42 cases(97.7%),while a conversion to open surgery was needed in 1 case because of uncontrolled hemorrhage after puncture.The overall stone clearance rate was 100%(42/42),including 38 cases of stone removal on one session and 4 cases of two-staged clearance.No serious complications,such as massive hemorrhage or neighboring organ injuries,were encountered.Re-examinations with B-ultrasonography or KUB at 1 month after operation showed no residual stones.Conclusions Ultrasound-guided percutaneous nephrostomy is minimally invasive,safe,and reliable.Proper use of this technique is crucial for a successful performance of percutaneous nephrolithotomy in the treatment of upper urinary tract calculus.