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KMID : 0377220000250010158
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Medical Journal of Chosun Univercity
2000 Volume.25 No. 1 p.158 ~ p.162
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A Case of Endoscopic Therapy of a Large Gallbladder Stone (Migrated from the Gallbladder through Cystic Duct after Endoscopic Sphincterotomy)
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Lee Eun-Woo
Yeo Hyang-Sun
Lim Dong-Yoon
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Abstract
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The reason why to migrate a large gallbladder stone into the common bile duct (CBD) remains to be established, but among various reasons the diameter of cystic duct appears to be the most important. None of the gallbladder stones with diameters greater than the cystic duct could be passed through it. However, pre-existing CBD stone increases biliary pressure that consequently dilates the cystic duct system retrogradely, allowing larger stones to migrate into the gut. Furthermore, sphincterotomy may actually prevent formation of gallbladder stone and enhance the removal of pre-existing stones from the gallbladder. We recently have experienced a case of a large CBD stone migrated from the gallbladder through the cystic duct after endoscopic sphincterotomy. The cholangitic symptoms were caused by the stone migrated from gallbladder, but several days later got well. So far any side effects related to this removed stone are not found out since we have successfully extracted a large CBD stone (3.5 x 2cm) with mechanical lithotripsy.
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KEYWORD
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A Large Gallbladder Stone, Endoscopic Sphincterotomy, Mechanical Lithotripsy
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