A CASE OF GALLBLADDER AND BILE DUCT STONES WITH BILIOBILIARY FISTULA SUCCESSFULLY TREATED BY DUODENOSCOPIC PULSED DYE LASER LITHOTRIPSY

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  • 経乳頭的レーザー切石が奏効したbiliobiliary fistula合併胆嚢胆管結石の1例

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Abstract

We managed a case of gallbladder and bile duct stones with a hiliobiliary fistula, using duodenoscopic pulsed dye laser lithotripsy. A 56-year-old man visited a local physician with complaints of abdominal fullness and dark urine. He was diagnosed as having obstractive jaundice with bile duct stones. He was transferred to our hospital for removal of the stones after endoscopic naso-biliary drainage. Lithotomy was performed four times using duodenoscopic pulsed dye laser methods because of alcoholic liver cirrhosis. The impacted stones in the common hepatic duct were fragmented without serious complica-tions and were completely removed from the bile duct. However, the gallstones continued to come out one after another from the bile duct through the biliobiliary fistula. Then, laser lithotomy was performed an additional four times and the stones in the bile duct were completely removed except for one large gallstone. The patient remains free of bile duct stones at two years and two months after discharge.

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