Barai Varsha, Hedawoo Jagadish, Changole Sanjay
Postgraduate Student, Department of Surgery, Government Medical College, Nagpur, India.
Associate Professor, Department of Surgery, Government Medical College, Nagpur, India.
Int J Surg Case Rep. 2017;30:162-164. doi: 10.1016/j.ijscr.2016.11.048. Epub 2016 Dec 7.
Choledocholithiasis is presence of stone in Common bile duct (CBD) which can be treated by endoscopy or surgery [1]. Retained foreign bodies like stents forms a nidus for stone formation resulting in pain, fever, jaundice.
60 years female patient admitted in surgery ward with features of cholangitis with computed tomography showing cholangitic abscess with dilated common bile duct and sludge around stent in situ. Stone was found at proximal end of stent during surgery.
Stents may remain without complications or may migrate, and rarely form nidus for stone formation. If kept for long time they lead to bacterial proliferation, biofilm formation and precipitation of calcium bilirubinate presenting as fever, pain, jaundice. Stent-stone complex can be treated endoscopically and surgically [6,7]. As stent can cause stone formation, infection and other complications, timely removal of stent should advised.
III-effects of stent in-situ should be explained, record should be maintained [8] and patient should be advised regular follow up and stent removal after 6 weeks.
胆总管结石是指胆总管（CBD）内存在结石，可通过内镜或手术治疗[1]。诸如支架等残留异物会形成结石形成的病灶，导致疼痛、发热、黄疸。
一名60岁女性患者因胆管炎症状入住外科病房，计算机断层扫描显示存在胆管脓肿，胆总管扩张，支架原位周围有淤泥。手术期间在支架近端发现结石。
支架可能无并发症留存，也可能移位，很少形成结石形成的病灶。如果长期留置，它们会导致细菌增殖、生物膜形成以及胆红素钙沉淀，表现为发热、疼痛、黄疸。支架-结石复合体可通过内镜和手术治疗[6,7]。由于支架会导致结石形成、感染和其他并发症，应建议及时取出支架。
应向患者解释支架原位的不良影响，做好记录[8]，并建议患者定期随访，6周后取出支架。
