Korean Journal of Gastrointestinal Endoscopy 2000;20(1): 21-25.
담낭이 있는 총담관 담석 환자의 내시경 치료에 대한 연구 ( Endoscopic Treatment of Bile Duct Calculi in Patients with Gallbladder in Situ )
강은희(Eun Hee Kang),나영숙(Young Sook Na),이성홍(Sung Hong Lee),최태영(Tae Young Choi),신원창(Won Chang Shin),이진호(Jin Ho Lee),최원충(Won Choong Choi),김관엽(Kwan Yop Kim)
Abstract
Background/Aims: Endoscopic sphincterotomy (EST) is a safe and effective method of managing CBD calculi. But whether EST of CBD calculi in patients with gallbladder in situ should be followed by routine post-EST cholecystectomy, is still a subject of controversy. The aims of this study was to identify the recurrence rate and predictive factors of biliary symptoms after EST of CBD calculi in patients with gallbladder in situ. Methods: 90 patients of CBD calculi with intact gallbladder treated with endoscopic sphincterotomy from 1992 to 1998 were reviewed. Follow up on the patients consisted of phone calls or personal interviews and the length of the follow up ranged from 6 to 77 months. Results: Cholecystectomy was required in 12 patients (13.3%) due to recurrent biliary symptoms and the remaining 78 patients (86.6%) were symptom free. Of the recurrence, 67.7% occurred within 12 months after EST and only one occurred after 5 years of follow-up. The risk of recurrence was higher in those patients with periampullary diverticulum in ERCP. Conclusions: The low recurrence rate of 13.3% after EST of CBD stones in patients with gallbladder in situ hardly justifies routine post-EST cholecystectomy and rather suggests selective post-EST cholecystectomy especially in high operative risk patients. (Korean J Gastrointest Endosc 2000;20:21~25)
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