BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotrips...BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal endoscope.CASE SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm.She was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary drainage.We attempted to fragment the stone by transhepatic cholangioscopy using EHL.However,the stones were too large and partly soft clay-like for lithotripsy.Next,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy.No complication was observed at the end of this procedure.CONCLUSION Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.展开更多
目的:总结腹腔镜胆总管切开探查取石术(laparoscopic common bile duct exploration,LCBDE)的临床价值及手术方法。方法:回顾分析2007年3月至2010年8月为85例胆管结石患者行LCBDE的临床资料。术中联合应用胆道镜、输尿管硬镜及气压弹道...目的:总结腹腔镜胆总管切开探查取石术(laparoscopic common bile duct exploration,LCBDE)的临床价值及手术方法。方法:回顾分析2007年3月至2010年8月为85例胆管结石患者行LCBDE的临床资料。术中联合应用胆道镜、输尿管硬镜及气压弹道碎石设备、L形腹腔镜胆道取石钳取石。结果:85例手术均获成功。78例经胆总管探查取石;7例经胆囊管胆总管探查取石。73例使用L形腹腔镜胆道取石钳取结石;12例使用输尿管硬镜气压弹道碎石设备碎石;6例为肝内胆管结石。62例放置T管引流,23例一期缝合胆总管。结论:腹腔镜胆总管探查取石术微创、安全、有效。联合应用胆道镜、输尿管硬镜及气压弹道碎石设备、L形腹腔镜胆道取石钳操作简捷、有效。展开更多
文摘BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal endoscope.CASE SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm.She was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary drainage.We attempted to fragment the stone by transhepatic cholangioscopy using EHL.However,the stones were too large and partly soft clay-like for lithotripsy.Next,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy.No complication was observed at the end of this procedure.CONCLUSION Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.
文摘目的:总结腹腔镜胆总管切开探查取石术(laparoscopic common bile duct exploration,LCBDE)的临床价值及手术方法。方法:回顾分析2007年3月至2010年8月为85例胆管结石患者行LCBDE的临床资料。术中联合应用胆道镜、输尿管硬镜及气压弹道碎石设备、L形腹腔镜胆道取石钳取石。结果:85例手术均获成功。78例经胆总管探查取石;7例经胆囊管胆总管探查取石。73例使用L形腹腔镜胆道取石钳取结石;12例使用输尿管硬镜气压弹道碎石设备碎石;6例为肝内胆管结石。62例放置T管引流,23例一期缝合胆总管。结论:腹腔镜胆总管探查取石术微创、安全、有效。联合应用胆道镜、输尿管硬镜及气压弹道碎石设备、L形腹腔镜胆道取石钳操作简捷、有效。
