EHLを用いた直接的経口胆管鏡下砕石術にて加療しえた肝内結石の1例

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  • 中路 聡
    医療法人鉄蕉会亀田総合病院／消化器内科
  • 平田 信人
    医療法人鉄蕉会亀田総合病院／消化器内科
  • 藤井 宏行
    医療法人鉄蕉会亀田総合病院／消化器内科

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  • A case of hepaticolithiasis treated by peroral direct cholangioscopic lithotripsy with electric hydraulic lithotripsy

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Percutaneous cholangiographical or surgical treatment has been performed for hepaticolithiasis. Peroral direct cholangioscopy using ultra-slim endoscope for the treatment of bile duct stones has come under spotlight with the development of nasal endoscope. We report a case of hepaticolithiasis treated by peroral direct cholangioscopic lithotripsy with electric hydraulic lithotripsy. The case is a 87-year-old male with multiple hospitalization for recurrent cholangitis caused by hepaticolithiasis. Percutaneous cholangiographical treatment was not indicated because there was no distal bile duct dilatation. Stone was impacted at the bifurcation of posterior segment. Also, there were many stones in the posterior branch. The stones were crushed by EHL, and removed by a basket catheter. After the procedure, intrahepatic bile duct was clear. In step with the aging of the population, the number of inoperable patients is increasing. Peroral direct cholangioscopic lithotripsy with electric hydraulic lithotrips is useful as a less-invasive treatment method.

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