Korean J Gastrointest Endosc > Volume 15(4); 1995 > Article
Korean Journal of Gastrointestinal Endoscopy 1995;15(4): 697-703.
원저 : 담도 췌장 ; 내시경적 담관결석 제거술의 임상적 고찰 ( Original Articles : Biliary Tract & Pancreas ; Endoscopic Removal of Bile Duct Stones )
정문관, 이현우, 장병익, 김태년, 김기덕, 서정일 (Moon Kwan Chung, Hyun Woo Lee, Byeong Ik Jang, Tae Nyeun Kim, Ki Duk Kim and Jeong Ill Suh)
From January 1988 to December 1994, endoscopic sphincterotomy with stone extraction was attempted in 395 patients with common duct stones at Yeungnam University Hospital. Endoscopic sphincterotomy was successful in 389 patients(98.5 %), and clearance of the duct was achieved in 364 patients with an overall success rate of 92.2%. After sphincterotomy, stone extraction by basket or balloon was undertaken in 298 patients without lithotripsy, and stones could be extracted after fragmentation of stones in 19 patients. In 47 patients, stones were passed into duo denum spontaneously. There were 6 cases of sphincterotomy failure due to large periampullary diverticulum or previous gastrojejunostomy. In patients with success ful sphincterotomy, endoscopic stone extraction was failed in 25 cases due to 14 large stones, 5 bile duct strictures, 4 impacted stones, and 2 cases of technical fail ure. Complications were developed in 13 patients(3.3%); 8 pancreatitis and 5 bleedings. All of them were improved with medical therapy only. Despite relatively high success rate and low complications of the endoscopic management of choledocholithiasis, there were significant difficulties in removing large stones. Developement of more effective and inexpensive methods of lithotripsy, and the search for rapidly effective solvent dissolving stones were needed. (Kor J Gastrointest Endosc 15: 697-703, 1995)
Key Words: Choledocholithiasis , ERCP , Endoscopic sphincterotomy
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