Schoonjans R, De Man M, Aerts P, Van der Spek P, Van Steenberge R, Lepoutre L
Department of Gastroenterology, Hospital Onze Lieve Vrouw, Aalst, Belgium.
Am J Gastroenterol. 1994 Sep;89(9):1573-6.
We report a case of cholangitis, liver abscess, and common bile duct stones in a patient with a benign stricture at a choledochojejunal anastomosis, 3 yr after a complicated duodenohemipancreatectomy. Because surgical reintervention seemed inappropriate, a percutaneous transhepatic balloon dilation was performed after temporary internal-external biliary drainage. Extracorporeal shockwave lithotripsy (ESWL) was successfully applied to fragment all common bile duct stones, with subsequent spontaneous evacuation of all stone fragments through the dilated bilioenteric anastomosis. Only one similar case report has been published before (1), though with a different sequence of therapeutic modalities. Moreover, according to our literature review, this is the first report of ESWL of common bile duct stones by means of the Dornier Compact Lithotriptor (Dornier, Germany) with electromagnetic shockwave source.
我们报告了1例在复杂十二指肠半胰切除术后3年，胆总管空肠吻合口出现良性狭窄的患者，并发胆管炎、肝脓肿和胆总管结石。由于手术再次干预似乎不合适，因此在进行临时内外胆管引流后，实施了经皮经肝胆囊扩张术。体外冲击波碎石术（ESWL）成功应用于粉碎所有胆总管结石，随后所有结石碎片通过扩张的胆肠吻合口自行排出。此前仅发表过1例类似病例报告（1），不过治疗方式顺序不同。此外，根据我们的文献综述，这是首例使用德国多尼尔公司带有电磁冲击波源的多尼尔紧凑型碎石机对胆总管结石进行ESWL治疗的报告。
