Korean Journal of Gastrointestinal Endoscopy 1997;17(5): 648-655.
원저 : 담도 췌장 ; 경피경간적 담도내시경을 이용한 거대 총담관결석의 전기수압쇄석술과 Endocoil 삽입 ( Original Articles : Biliary Tract & Pancreas ; Electrohydraulic Lithotripsy ( EHL ) of Large Common Bile Duct Stone and Endocoil Insertion with Percutaneous Transhepatic Choledochoscopy )
조형철, 오기창, 조장현, 추진호, 김원석, 김명원, 강명원, 여향순, 박홍배 (Hyung Chul Cho, Ki Chang Oh, Jang Hyun Cho, Jin Ho Chu, Weon Seuk Kim, Myung Won Kim, Myung Weon Kang, Hyang Soon Yeo and Hong Bae Park)
Abstract
Background/Aims: Electrohydraulic lithotrypsy(EHL) under cholangioscopic control has been performed for difficult bile duct stones. The percutaneous transhepatic approach is technically easy and useful in diagnosis and treatment of bile duct obstruction and stones. Biliary stenting with self expanding metal stent is gaining increasingly wider acceptance as a palliative treatment of bile duct obstruction. Methods: Between Sep. 1994 and Sep. 1996, EHL under choledochoscopy by percutaneous transhepatic approach was performed in 30 cases(Male: 13, Female: 17). After PTBD with 7F pig tail catheter, the percutaneous transhepatic passage was dilated over guide wire with dilaters of increasing size up to 16Fr in 3-Sdays. In one week, after fistula had been estabilished, choledochoscopy was performed. Results: (1) Mean age was 61.3 years. Mean stone number was 2.5. And mean stone size was 1.6 x 2.3 cm. (2) Com.plete removal of the stone was achieved in all patients(100%). (3) There were no serious complications. (4) In six cases, Endocoils were implanted with successful decompression of obstructions and simultaneous removal of biliary stones located at both side of stricutre. Conclusions: Percutaneous transhepatic choledochoscopy is easy and safe and assists in the diagnosis and treatment of biliary stricture and the management of difficult CBD stone. (Korean J Gastrointest Endosc 17: 648-655, 1997)
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