1/137. Laparoscopic choledochoduodenostomy.Laparoscopic cholecystectomy has become the gold standard for treatment of patients with symptomatic cholelithiasis. Management of common bile duct stones in the era of laparoscopy is an area of controversy. Although perioperative endoscopic retrograde cholangiography remains as a widely used procedure, experience is accumulating on the exploration of the common bile duct with the laparoscope. A biliary drainage procedure is indicated in selected patients with choledocholithiasis. Initially described by Reidel in 1892, side-to-side choledochoduodenostomy has become a popular biliary-enteric anastomosis technique in the last century. We describe two patients with recurrent choledocholithiasis and biliary obstruction due to benign biliary strictures. Both patients underwent laparoscopic common bile duct exploration and stone extraction. A side-to-side choledochoduodenostomy is then performed laparoscopically as a drainage procedure. Laparoscopic choledochoduodenostomy resulted in resolution of jaundice and relief of biliary obstruction. Laparoscopic choledochoduodenostomy can be an acceptable alternative to the open choledochoduodenostomy. In addition to a tension-free anastomosis and an adequate-sized stoma, intracorporeal suturing and knot-tying skills are also essential to the success of this procedure.- - - - - - - - - - ranking = 1keywords = lithiasis (Clic here for more details about this article) |
2/137. Percutaneous papillary balloon dilatation as a therapeutic option for cholecystocholedocholithiasis in the era of laparoscopic cholecystectomy.The present study was conducted to evaluate the effectiveness of percutaneous papillary balloon dilatation (PPBD) as a therapeutic option for cholecystocholedocholithiasis, in combination with laparoscopic cholecystectomy (LC). A total of 15 patients with both bile duct and gallbladder stones were clinically investigated. In 14 patients, PPBD was performed 2 to 7 days prior to LC, while in the remaining patient, PPBD was performed immediately after LC under general anesthesia in one continuous session. The bile duct stones were successfully pushed out into the duodenum in all the patients, seven of whom required two sessions for complete stone clearance, while the other eight needed only one session. Two patients had bile duct stones larger than 12 mm in diameter, necessitating electrohydraulic lithotripsy under cholangioscopy. The insertion of a percutaneous transhepatic biliary drainage tube did not cause intra-abdominal adhesions severe enough to contraindicate the use of LC. The operation times for LC varied from 80 to 184 min, with a mean operation time of 132 min, and the average postoperative and overall hospital stays were 9 and 26 days, respectively. There were no deaths or major complications, apart from transient hyperamylasemia. The findings of this study indicate that PPBD combined with LC is a safe and effective therapeutic option for cholecystocholedocholithiasis.- - - - - - - - - - ranking = 2keywords = lithiasis (Clic here for more details about this article) |
3/137. Percutaneous and endoscopic management of bile leak following endoscopic stone retrieval--a case report.Endoscopic sphincterotomy with stone removal is the method of choice for the treatment of choledocholithiasis. The main complications of this procedure are bleeding, pancreatitis, intestinal perforation and cholangitis. Herein, we report on a case of bile peritonitis in a patient who underwent sphincterotomy and stone retrieval. The literature regarding the etiology and management of bile peritonitis is also reviewed.- - - - - - - - - - ranking = 0.33333333333333keywords = lithiasis (Clic here for more details about this article) |
4/137. biliary tract duplication accompanied by choledocholithiasis: report of a case.Duplication of the biliary tract is extremely rare. In fact, to the best of our knowledge, only four previous reports of pediatric patients with this disease have been documented in the Japanese literature. This anomaly was diagnosed by perioperative endoscopic retrograde cholangiopancreatography (ERCP) in three of these patients, and incidentally during surgery for congenital biliary dilatation in the other one. We report herein a case of biliary tract duplication which was diagnosed by T-tube cholangiography, only in the oblique view, after cholecystectomy and choledochotomy with T-tube drainage. The patient was a 13-year-old girl who was initially diagnosed as having choledocholithiasis based on the results of preoperative and intraoperative cholangiography; however, a postoperative T-tube cholangiography revealed residual stones. At this point, duplication of the biliary tract was diagnosed only in the first oblique view. reoperation was carried out 26 days after the first operation. The biliary tract was dissected completely from the pancreaticobiliary junction to the left and right hepatic ducts in the porta hepatis and found to be duplicated from the level of porta hepatis to the suprapancreatic area. We report our experience of this case, followed by a discussion on the relevant literature.- - - - - - - - - - ranking = 1.6666666666667keywords = lithiasis (Clic here for more details about this article) |
5/137. Sequential treatment of the common bile duct stones and cholecystolithiasis.The orthodox method of the treatment of gallstone disease is laparoscopic cholecystectomy (LC) days or weeks after endoscopic retrograde cholangiopancreatography endoscopic spincterotomy (ERCP ES). It can be advantageous from the point of financing, that is double reimbursement (2 x DRG). On the other hand there are some disadvantages of this procedure: longer hospital stay, further suffering of the patient, difficulties at operation because of inflammation provoked by ERCP (11% 14/120 in 3 month). We report on our experience with the treatment of common bile duct stones within 24 h by sequential endoscopic-laparoscopic management. The gallstone disease of a 32 year old woman was diagnosed by ultrasonography and laboratory tests. She had ERCP ES in the morning and LC 7 hours later. There was no complication and the patient was discharged already on the 3rd day.- - - - - - - - - - ranking = 1.3333333333333keywords = lithiasis (Clic here for more details about this article) |
6/137. Is choledocholithiasis a late complication of nonresectional therapies for hepatocellular carcinoma?We present 3 patients who developed choledocholithiasis 10, 13, and 12 months after percutaneous ethanol injection and/or transcatheter arterial chemoembolization for hepatocellular carcinoma. Since none of these patients had stones in the gallbladder or in the bile ducts before treatment, bile duct stones might have resulted from local injury in the bile ducts by percutaneous ethanol injection and/or transcatheter arterial chemoembolization. choledocholithiasis may be a late complication of nonresectional and local therapies for hepatocellular carcinoma tumors.- - - - - - - - - - ranking = 2keywords = lithiasis (Clic here for more details about this article) |
7/137. Successful treatment of percutaneous transhepatic papillary dilation in patients with obstructive jaundice due to common bile duct stones after Billroth II gastrectomy: report of two emergent cases.Successful treatment of two patients with obstructive jaundice due to choledocholithiasis after Billroth II gastrectomy was performed by elimination of stones by percutaneous transhepatic balloon dilatation of the sphincter of oddi. Patient 1 was an 82-year-old man and Patient 2 was a 73-year-old man. Both patients presented with obstructive jaundice. The papilla was not observed in either patient because of previous Billroth II gastrectomy. Because an endoscopic approach was impossible, percutaneous transhepatic cholangiodrainage (PTCD) was performed to alleviate jaundice. choledocholithiasis was treated as follows: The sphincter of oddi was dilated by percutaneous transhepatic balloon, and stone particles were removed from the papilla with a stone-eliminating balloon catheter via the same route of PTCD. This method is less invasive than the percutaneous transhepatic cholangioscopic method, and the use of existing appliances such as a balloon for papillary dilation is possible. Hence, this method appears to be an effective and simple method for the treatment of choledocholithiasis after gastrectomy that is difficult to treat endoscopically.- - - - - - - - - - ranking = 1keywords = lithiasis (Clic here for more details about this article) |
8/137. A case report of spherocytosis presenting with choledocholithiasis in early childhood and a review of the literature.This is a report of spherocytosis presenting unusually early with choledocholithiasis secondary to low grade haemolysis.- - - - - - - - - - ranking = 1.6666666666667keywords = lithiasis (Clic here for more details about this article) |
9/137. Laparoscopic treatment for biliary ascariasis.Biliary ascariasis is one of the most common types of ascaris infections. The current treatments are helminthic drug therapy, endoscopic extraction, and surgical extraction. A case of biliary ascariasis and cholecystocholedocholithiasis was successfully treated by laparoscopic extraction of the living worm and biliary stones. This procedure was found to be very effective for biliary ascariasis with biliary stones, and it holds promise for similar cases in the future.- - - - - - - - - - ranking = 0.33333333333333keywords = lithiasis (Clic here for more details about this article) |
10/137. Long-term stenting for choledocholithiasis.Endoscopic biliary sphincterotomy and stone removal has become the standard of care for choledocholithiasis. Surgical intervention has been undertaken when stones cannot be removed endoscopically. In such patients who are high risk surgical candidates, an alternative therapy is the endoscopic placement of long-term plastic stents to allow biliary decompression. Though such stents usually occlude by three months, they may act as a wick to allow drainage of bile into the duodenum. This case report describes a patient with choledocholithiasis who was treated for 19 months with a biliary stent before expiring from unrelated causes.- - - - - - - - - - ranking = 2keywords = lithiasis (Clic here for more details about this article) |
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