Korean Journal of Gastrointestinal Endoscopy 1998;18(6): 863-871.
원저 : 담도 췌장 ; 담낭관결석의 내시경적 치료 ( Original Articles : Biliary Tract & Pancreas ; Endoscopic Treatment with ESWL of Impacted Cystic Duct Stones )
문종호, 조영덕, 박규호, 홍수진, 송동화, 김연수, 이문성, 심찬섭 (Jong Ho Moon, Young Deok Cho, Gyu Ho Park, Su Jin Hong, Dong Hwa Song, Yun Soo Kim, Moon Sung Lee and Chan Sup Shim)
Abstract
Background/Aims: The established treatment for cystic duct stones is surgery, but nonoperative removal of gallstones through percutaneous cholecystostomy can also be a useful procedure in patients at high risk for surgery. Conventional methods using endoscopic or percutaneous stone extraction usually fail due to the inability to access or capture the cystic duct stones in the narrow, long, spiral portion of the cystic duct, especially in impacted cases. As a result stone fragmentation is required during endoscopic stone removal. It is impossible for an electrohydraulic lithotripsy (EHL) to gain access to the stones, due to the rigid distal metal tip of the lithotripter and the narrowness of the long, spiral cystic duct. Using extracorporeal shockwave lithotripsy (ESWL) to disintegrate gallstones is a more effective method for removal of cystic duct stones. Experiences of endoscopic treatment for cystic duct stones of patients with high risk for surgery were reviewed, and conclusions are included in this study. Methods: Patient records of endoscopic management of cystic duct stones between January, 1994 and December, 1997, were reviewed for methods and results of treatment. Most of the patients had undergone lithotripsy followed by percutaneous transhepatic cholecystostomy. (Korean J Gastrointest Endosc 18: 863-871, 1998) (continue)
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