Korean J Gastrointest Endosc > Volume 35(6); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(6): 451-456.
내시경 큰 풍선 유두 확장술을 통한 투석 환자의 큰 담관결석의 치료 1예
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
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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