The Role of Endoscopic Biliary Drainage without Sphincterotomy in Gallstone Patients with Cholangitis and Suspected Common Bile Duct Stones Not Detected by Cholangiogram or Intraductal Ultrasonography

궁현정; 문정호; 이윤나; 최현종; 최서연; 최문환; 김민진; 이태훈; 박상흠; 이혜경

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자료유형: 학술저널

저자정보: 궁현정 문정호 이윤나 최현종 최서연 최문환 김민진 이태훈 박상흠 이혜경

저널정보: 거트앤리버 발행위원회 Gut and Liver Gut and Liver 제11권 제3호

발행연도: 2017.1

수록면: 434 - 439 (6page)

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Background/Aims: Treatment for cholangitis without common bile duct (CBD) stones has not been established in patients with gallstones. We investigated the usefulness of endoscopic biliary drainage (EBD) without endoscopic sphincterotomy (EST) in patients diagnosed with gallstones and cholangitis without CBD stones by endoscopic retrograde cholangiopancreatography (ERCP) and intraductal ultrasonography (IDUS). Methods: EBD using 5F plastic stents without EST was performed prospectively in patients with gallstones and cholangitis if CBD stones were not diagnosed by ERCP and IDUS. After ERCP, all patients underwent laparoscopic cholecystectomy. The primary outcomes were clinical and technical success. The secondary outcomes were recurrence rate of biliary events and procedure-related adverse events. Results: Among 187 patients with gallstones and cholangitis, 27 patients without CBD stones according to ERCP and IDUS received EBD using 5F plastic stents without EST. The stents were maintained in all patients until laparoscopic cholecystectomy, and recurrence of cholangitis was not observed. After cholecystectomy, the stents were removed spontaneously in 12 patients and endoscopically in 15 patients. Recurrence of CBD stones was not detected during the follow-up period (median, 421 days). Conclusions: EBD using 5F plastic stents without EST may be safe and effective for the management of cholangitis accompanied by gallstones in patients without CBD stones according to ERCP and IDUS.

#Cholangitis #Gallstones #Sphincterotomy #endoscopic #Intraductal ultrasonography

참고문헌 (23)

참고문헌 신청

Ohashi A / 2009 / Risk factors for recurrent bile duct stones after endoscopic papillary balloon dilation: long-term follow-up study / Dig Endosc 21:73~77

ASGE Standards of Practice Committee / 2010 / The role of endoscopy in the evaluation of suspected choledocholithiasis / Gastrointest Endosc 71 : 1 ~ 9

Bergman JJ / 1996 / Long-term followup after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age / Gastrointest Endosc 44 : 643 ~ 649

Brand B / 2001 / Outcome of endoscopic sphincterotomy in patients with pain of suspected biliary or papillary origin and inconclusive cholangiography findings / Endoscopy 33

Chak A / 1999 / Prospective assessment of the utility of EUS in the evaluation of gallstone pancreatitis / Gastrointest Endosc 49 : 599 ~ 604

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