Atar Eli, Neiman Chaim, Ram Eduard, Almog Mazal, Gadiel Itai, Belenky Alexander
Department of Diagnostic Radiology, Unit of Vascular and Interventional Radiology, Rabin Medical Center (Hasharon Campus), Petah Tikva, Israel.
Isr Med Assoc J. 2012 Jun;14(6):354-8.
The presence of stones in the common bile duct (CBD) may cause complications such as obstructing jaundice or ascending cholangitis, and the stones should be removed.
To assess the efficacy of percutaneous elimination of CBD stones from the gallbladder through the papilla.
During a 4 year period, six patients (five men and one woman, mean age 71.5 years) who had CBD stones and an existing gallbladder drain underwent percutaneous stone push into the duodenum after balloon dilatation of the papilla, with a diameter equal to that of the largest stone. Access into the CBD was from the gallbladder, using an already existing percutaneous gallbladder drain (cholecystostomy tube).
Each patient had one to three CBD stones measuring 7-14 mm. Successful CBD stone elimination into the duodenum was achieved in five of the six patients. The single failure occurred in a patient with choledochal diverticulum, who was operated successfully. There were no major or minor complications during or after the procedures.
Trans-cholecystic CBD stone elimination is a safe and feasible percutaneous technique that utilizes existing tracts, thus obviating the need to create new percutaneous access. This procedure can replace endoscopic or surgical CBD exploration.
胆总管（CBD）结石的存在可能导致诸如梗阻性黄疸或化脓性胆管炎等并发症，结石应予清除。
评估经乳头从胆囊经皮清除胆总管结石的疗效。
在4年期间，6例患有胆总管结石且已有胆囊引流管的患者（5例男性，1例女性，平均年龄71.5岁），在乳头球囊扩张至最大结石直径后，经皮将结石推入十二指肠。通过已有的经皮胆囊引流管（胆囊造瘘管）从胆囊进入胆总管。
每位患者有1至3枚胆总管结石，直径7 - 14毫米。6例患者中有5例成功将胆总管结石排入十二指肠。唯一失败的1例患者患有胆总管憩室，后经手术成功治疗。手术期间及术后均无严重或轻微并发症。
经胆囊清除胆总管结石是一种安全可行的经皮技术，利用现有的通道，无需建立新的经皮通道。该手术可替代内镜或手术探查胆总管。
