高齢者総胆管結石症に対する低侵襲治療としてのステント留置術の検討 [in Japanese] Endoscopic stenting : minimal invasive therapy of common bile duct stone for the elderly patient [in Japanese]
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Endoscopic removal of common bile duct stones (CBDS) after endoscopic sphincterotomy is a widely accepted procedure. But, we need long time and several times approach for the treatment when the stone is large and multiple. For patients with major medical problems or elder patients, endoscopic plastic stent placement may help to prevent stone impaction and cholangititis with minimaly damage. However, there are some problems because this treatment is not fundamental treatment. In this report, We described the experience of biliary stent placement use in elderly 15 patients with CBDS. January 2008 to December 2009, 62 patients with CBD stones were referred for endscopic stone removal. In 15 of these patients (9 men, 6 women; median age 84.3 years,range 76～102 years) were not be cleared endoscopically because of their condition and plastic stent was inserted. We use a 7Fr straight plastic stent for 1～9 patient, while the remaining 6 received two 7Fr curved plastic stent. The maximum diameter of stones ranges from 1.5～3.5cm with a median of 1.9cm. All patients were discharged from hospital. In patient stay ranged from 1～7days (median 4.2days). 9of 15 patients required stent replacement owing stent incomplete occlusion (first symptom of stent occlusion ; 1 patient jaundice, 8 patient cholangititis). 6 patients (received two curved stent) passed well after treatment during a follow-up period (7months~) <br> Our results show that long-term biliary stent placement is an advisable alternative therapeutic modality for high-risk and debilitates patients with CBDS.
- Progress of Digestive Endoscopy
Progress of Digestive Endoscopy 77(2), 142-143, 2010
Japan Gastroenterological Endoscopy Society Kanto Chapter