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KMID : 0614619930250051004
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Korean Journal of Gastroenterology
1993 Volume.25 No. 5 p.1004 ~ p.1010
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Results of Postoperative Cholangioscopy Via T-Tube Tract in Extraction of Retained Gallstones
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문종호
송동화/박찬욱/이준성/이문성/김진홍/조성원/심차섭/송영식
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Abstract
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Intrahepatic duct stones are frequent, and provide a quite different spectrum of problems to surgeons in the eastern hemisphere. Gallstones in both lobe of intrahepatic ducts may be more troublesome because sometimes they cannot be completely
removed by
conventional surgical procedures of tone extraction. The use of a flexible fiberoptic cholangioscope under fluoroscopic guidance combined with electrohydraulic lithotripter makes it possible to remove intrahepatic stones completely in the
majority
of
cases.
59 patients with postoperative retained gallstones (intrahepatic stones in 52. Extrahepatic stones in 4, intra and extrahepatic stones in 3) were treated with postoperative cholangioscopy and electrohydraulic lithotripter via T-tube tract.
Complete
extraction of stones were achieved in 55 of total 59 patients (93.2%), and in 51 of 55 patients with intrahepatic stones (92.7%). The number of sessions of choledochoscopy required for complete removal of retained gallstones was from 1 to 9
(mean:
2.7).
Fallure of complete removal of retained gallstones were attriouted to a the combination of stenosis and acute angulation in 3 patients with intrahepatic duct stones, and only acute angulation in 1 patient with intrahepatic duct stones.
Complications
occurred in 6 of 161 sessions (hemobilia in 4, bile duct perforation in 1, and loss of tract in 1), but no inortality related to this procedure occurred in any of the patients. The postoperative cholangioscopy combined with electrohydraulic
lithotripter
is considered to be a safe and satisfactory method for the treatment of retained gallstones, especially intrahepatic stones.
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KEYWORD
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