EST 後再発し, ESWL により治療しえた巨大総胆管結石症の1例

DOI 被引用文献1件 参考文献20件

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  • An extremely large common bile duct stone treated by extracorporeal shockwave lithotripsy after endoscopic insertion of a nasobiliary tube; Case report

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We report a patients with an extremely large common bile duct stone which was successfully treated by extracorporeal shockwave lithotripsy (ESWL) after endoscopic insertion of a nasobiliary tube. The patient was a 79-year-old woman who presented with fever, epigastric pain, and jaundice. She was in a state of shock on admission. Endoscopic sphincterotomy had been performed for common bile duct stones 7 years ago. Abdominal ultrasonography revealed a large stone in the common bile duct, so she was diagnosed as having acute obstructive suppurative cholangitis. ERG was performed immediately and a nasobiliary drainage tube was inserted subsequently. The tube cholangiography showed a huge common bile duct stone more than 4×7 cm in diameter. Endoscopic treatment such as mechanical lithotripsy and removal was considered impossible, so ESWL was performed. The stone was fragmented after 8 sessions, as shown by tube cholangiography, and the fragments were cleared completely without complications. This case demonstrates that even huge stones that are difficult to treat by any other method may be handled comparatively easily and safely by ESWL.

収録刊行物

  • Tando

    Tando 11 (2), 203-208, 1997

    Japan Biliary Association

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