Chikamori Fumio, Ueta Koji, Onishi Kazuhisa, Yoshida Mitsuteru, Tanida Nobuyuki, Yamai Hiromichi, Matsuoka Hisashi, Hokimoto Norihiro, Iwabu Jun, Yamada Ryo, Mizobuchi Kai, Shimizu Shigeto, Sharma Niranjan
Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562, Japan.
Adv Train Gastroint & Organ Transp Surgery, 12 Scotland St, Dunedin, 9016, New Zealand.
Radiol Case Rep. 2022 Oct 28;18(1):100-107. doi: 10.1016/j.radcr.2022.09.078. eCollection 2023 Jan.
A 71-year-old woman was referred to our department for abdominal pain. She was diagnosed with acute obstructive cholangitis due to cystic duct and bile duct stones after cholecystectomy and Roux-en-Y gastrojejunostomy. Two years ago, the patient underwent endoscopic and laparoscopic treatment for cystic duct and bile duct stones, however, the stones remained. This time, she was treated with stone removal using percutaneous papillary balloon dilatation (PPBD). Large stones in the common hepatic and bile ducts were crushed by electrohydraulic lithotripsy and then pushed out into the duodenum through the dilated papilla of Vater using a balloon catheter covered with the sheath and cholangioscopy. Stone in the cystic duct was pulled to the common bile duct and pushed to the duodenum. Stone removal using PPBD is an excellent alternative for patients with cystic duct and bile duct stones unable to be treated with endoscopic or laparoscopic stone removal.
一名71岁女性因腹痛被转诊至我科。她在胆囊切除术和Roux-en-Y胃空肠吻合术后,因胆囊管和胆管结石被诊断为急性梗阻性胆管炎。两年前,该患者接受了内镜和腹腔镜治疗胆囊管和胆管结石,但结石仍留存。此次,她接受了经皮乳头球囊扩张术(PPBD)取石治疗。肝总管和胆管内的大结石通过电液压碎石术粉碎,然后使用覆盖有鞘管的球囊导管和胆管镜经扩张的十二指肠乳头将结石推送至十二指肠。胆囊管内的结石被拉至胆总管并推送至十二指肠。对于无法通过内镜或腹腔镜取石治疗的胆囊管和胆管结石患者,PPBD取石是一种很好的替代方法。