Okada Yasuhiro, Miyamoto Masatoshi, Yamazaki Toru, Motoi Isamu, Kuribayashi Masato, Kodama Koichi
Department of Paediatric Surgery, Toyama City Hospital, Imaizumi, Toyama, Japan.
Pediatr Surg Int. 2007 Apr;23(4):357-60. doi: 10.1007/s00383-006-1777-6. Epub 2007 Feb 15.
We report a case of bile duct stones in which piezoelectric extracorporeal shockwave lithotripsy (ESWL) was highly effective for the clearance of stones. A 16-year-old girl, who had undergone excision of a choledochal cyst when she was 3 years old, presented a spiking fever and colic abdominal pain. Radiological investigations showed two large stones incarcerating to the proximal end of hepatico-jejunostomy anastomosis. Massive debris was also present in intrahepatic bile duct proximal to the anastomosis. She underwent piezoelectric ESWL with an EDAP LT02 lithotripter. An average of 40 min ESWL session was repeated at intervals of 2 or 3 days. Neither anesthetic nor sedative treatment was required. By the end of the sixth session, the stones incarcerated were fragmented and the debris in the intrahepatic bile duct was completely eliminated. We conclude that piezoelectric ESWL is a less invasive, effective and repeatable method, therefore, it could be a treatment of choice for bile duct stone formation after choledochal cyst excision.
我们报告一例胆管结石病例，其中压电体外冲击波碎石术（ESWL）对结石清除非常有效。一名16岁女孩，3岁时接受了胆总管囊肿切除术，出现高热和腹部绞痛。影像学检查显示，两颗大结石嵌顿在肝空肠吻合口近端。吻合口近端肝内胆管也存在大量碎片。她使用EDAP LT02碎石机接受了压电ESWL治疗。平均40分钟的ESWL治疗以2或3天的间隔重复进行。无需麻醉或镇静治疗。到第六次治疗结束时，嵌顿的结石被击碎，肝内胆管中的碎片被完全清除。我们得出结论，压电ESWL是一种侵入性较小、有效且可重复的方法，因此，它可能是胆总管囊肿切除术后胆管结石形成的首选治疗方法。
