| 내시경 큰 풍선 유두 확장술을 통한 투석 환자의 큰 담관결석의 치료 1예 |
| 조승현ㆍ이동기ㆍ이병준ㆍ임현철ㆍ박찬익 |
| 연세대학교 의과대학 내과학교실 |
| Endoscopic Papillary Large Balloon Dilatation for Large Biliary Stones in a Hemodialysis Patient: A Case Report |
| Seung Hyun Cho, M.D., Dong Ki Lee, M.D., Byung Jun Lee, M.D.,Hyun Chul Lim, M.D. and Chan Ik Park, M.D. |
| Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea |
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| Abstract |
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In retrieving bile duct stones, full-endoscopic sphincterotomy (EST) with endoscopic mechanical lithotripsy (EML) is considered as a traditional method, and balloon dilation of the papillary sphincter has also been used. Recent studies have reported that mid-EST and endoscopic papillary large balloon dilatation (EPLBD) was as useful as full-EST with EML, without serious complications. In patients with coagulopathy, such as end-stage renal disease, even a small incision of the sphincter could cause profuse bleeding. In such patients, balloon dilation of the sphincter is a preferred technique over EST. A prior Billroth-II operation renders EST more difficult and increases the risk of a complication. In these patients, the use of EPBD is also preferred as well. We report a case of successfully retrieving large bile duct stones by EPLBD without EST, in a patient who had a prior Billroth-II operation, and is undergoing hemodialysis. The patient is free of complications, such as bleeding or acute pancreatitis. (Korean J Gastrointest Endosc 2007;35:451-455) |
| Key Words:
Endoscopic papillary large balloon dilatation, Mid-endoscopic sphincterotomy, Hemodialysis, Billroth-II |
| 주요어:
큰 풍선 확장술, 중절개, 혈액투석, Billroth-II |
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