Al-Zubaidi Ali Mothanna, Al-Zubaidi Abdo Hasan, Qureshi Laeeque Ahmed, Al-Haroon Esam Elldein
Department of Gastroenterology and Endoscopy, King Khalid Hospital, Najran, Saudi Arabia.
Department of General Surgery and Endoscopy, King Khalid Hospital, Najran, Saudi Arabia.
J Coll Physicians Surg Pak. 2014 Nov;24(11):861-2.
An elderly female was admitted with obstructive jaundice, secondary to an impacted 1.7 cm size stone in distal CBD. Cholangiogram obtained during ERCP revealed dilated biliary system with large, immobile stone at the lower end of CBD. A large size sphincterotomy was performed and stone extraction using biliary balloon / dormia basket attempted which was unsuccessful as the stone was impacted in distal CBD. Therefore, a plastic biliary stent of 9 cm/8.5 french size was inserted successfully to secure the biliary drainage. Patient improved clinically and discharged home on ursodeoxycholic acid. Four weeks later, she presented to emergency department with signs of cholangitis. An emergency ERCP was performed. The stent had migrated up completely into the left intra hepatic duct. In this session, the stone was extracted and biliary drainage secured. Migrated stent was removed later on by another ERCP procedure.
一名老年女性因胆总管远端1.7厘米大小结石嵌顿继发梗阻性黄疸入院。内镜逆行胰胆管造影（ERCP）期间获得的胆管造影显示胆道系统扩张，胆总管下端有大的、固定不动的结石。进行了大尺寸括约肌切开术，并尝试使用胆道球囊/取石篮取石，但因结石嵌顿在胆总管远端而未成功。因此，成功插入了一根9厘米/8.5法式规格的塑料胆管支架以确保胆汁引流。患者临床症状改善，服用熊去氧胆酸后出院。四周后，她因胆管炎症状就诊于急诊科。进行了急诊ERCP。支架已完全向上迁移至左肝内胆管。在这次手术中，取出了结石并确保了胆汁引流。后来通过另一次ERCP手术取出了迁移的支架。
