Korean Journal of Gastrointestinal Endoscopy 1999;19(1): 51-58.
총수담관 결석의 각종 내시경적 제거술의 효과 (Effects of Several Methods in Endoscopic Extraction of Common Bile Duct Stone )
이병석, 이상우, 성재규, 이승민, 이경태, 김석현, 김진희, 김남재, 이헌영 (Byung Seok Lee, Sang Oo Lee, Jae Kyu Seong, Seung Min Lee, Keong Tae Lee, Seok Hyun Kim, Jin Hee Kim, Nam Jae Kim and Heon Young Lee)
Abstract
Background/Aims: The objective of this paper is to compare the effectiveness of com-mon bile duct stone extraction by conditions and methods. Methods: Endoscopic sphinc-terotomies with stone extraction were practiced in 71 patients with common bile duct stones by basket extraction, balloon extraction and mechanical lithotripsy. Results: 1) In 71 patients with CBD stone, sex distribution showed predominence in females (56.3%) and most of the cases were over 60 years old. 2) After sphincterotomy, the overall success rate of the stone extraction was 87.3% (with balloon and basket or mechanical lithotrispy). The removal methods of the stone extractions were varied, but the most commonly used method was basket extraction (50.7%). 3) The complications of sphicterotomy were noted in 10 cases and in 8 cases minor bleeding was stopped with a hypertonic saline epinephrine injection. 4) After the stone extraction, counts and levels of leukocyte, aspartate transami-nase, alanine transaminase, alkaline phosphatase and total bilirubin were significantly improved (p ＜0.05). 5) Removal methods according to stone size did not show a signifi-cant difference, but the mean size of the stones was different. According to the several methods, the mean diameter of stones were different. The stone size was 1.1 cm in the case of spontaneous removal, 1.4 cm in balloon or basket removal, 1.9 cm in mechanical lithotripsy and 2.0 cm in surgical removal. Conclusions: Endoscopic stone extraction was effective and safe method with low rate of complications. However there were some significant difficulties in removing large or impacted stones, therefore EHL, ESWL or operation should be considered. (Korean J Gastrointest Endosc 19: 51 ∼58, 1999)
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