Liu Cui, Tian Lingyun, Ze Xingyu, Yang Ting, Wang Luowei, Li Zhaoshen
Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Gastroenterology, Digestive Endoscopy Center, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, China.
J Minim Access Surg. 2025 Jan 1;21(1):83-85. doi: 10.4103/jmas.jmas_286_23. Epub 2024 Oct 9.
Common bile duct (CBD) stones are usually caused by biliary tract infection, biliary stricture, duodenal peripapillary diverticulum, Oddis sphincter dysfunction, and so on. Treatment is preferably with endoscopic retrograde cholangiopancreatography (ERCP), where an iodine-containing contrast agent is injected into the CBD to display the stone under fluoroscopy and then to confirm complete removal of the stone(s). We described a 65-year-old woman with CBD stones who had undergone cardiac pacemaker implantation and was allergic to iodinated contrast media. We performed ERCP + lithotomy + stent implantation under local anesthesia, with injection of carbon dioxide instead of iodinated contrast into the CBD, and successfully visualized the stones under fluoroscopy and then confirmed complete removal of them. The patient was generally in good condition without complications. Thus, we have demonstrated in this case report that carbon dioxide can be used as a safe, economical, and effective alternative to iodinated contrast agent during ERCP.
胆总管结石通常由胆道感染、胆管狭窄、十二指肠乳头周围憩室、Oddi括约肌功能障碍等引起。治疗首选内镜逆行胰胆管造影（ERCP），即将含碘造影剂注入胆总管，在荧光透视下显示结石，然后确认结石已完全取出。我们描述了一名65岁患有胆总管结石的女性，她已植入心脏起搏器且对碘化造影剂过敏。我们在局部麻醉下进行了ERCP + 取石术 + 支架植入术，向胆总管内注入二氧化碳而非碘化造影剂，成功在荧光透视下看到结石，随后确认结石已完全取出。患者总体状况良好，无并发症。因此，我们在本病例报告中证明，在ERCP期间，二氧化碳可作为碘化造影剂的一种安全、经济且有效的替代品。
