West Sara, Shellenberger M Joshua
Department of Internal Medicine, Geisinger Medical Center, Danville, PA.
Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA.
ACG Case Rep J. 2016 Jan 20;3(2):118-20. doi: 10.14309/crj.2016.19. eCollection 2016 Jan.
In a patient found to have cholelithiasis and choledocholithiasis, a choledochoduodenal fistula was used to gain access to the bile duct. Due to severe stenosis and atrophy of the major papilla, cannulation was not possible. Stones were purposely impacted in the native ampulla to cause bulging and stretching of the stenosis. Once the stenosis was stretched, the bile and pancreatic duct were accessed via the native ampulla, allowing for stone removal.
在一名被诊断为胆结石和胆总管结石的患者中，利用胆总管十二指肠瘘来进入胆管。由于主乳头严重狭窄和萎缩，无法进行插管。特意将结石嵌顿在天然壶腹中，以使狭窄处膨出和扩张。一旦狭窄处得到扩张，即可通过天然壶腹进入胆管和胰管，从而取出结石。
