원위부 총담관 결석으로 오인된 결석을 동반한 총담관류 치료
Choledochocele containing a stone mistaken as a distal common bile duct stone
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors’ hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.
Abstract
A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors’ hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.
참고문헌 (20)
- Todani T, "Classification of congenital biliary cystic disease: special reference to type Ic and IVA cysts with primary ductal stricture", J Hepatobiliary Pancreat Surg, 10, pp.340~344 (2003)
- Sarris GE, "Choledochocele: case report, literature review, and a proposed classification", Surgery, 105, pp.408~414 (1989)
- Law R, "Diagnosis and treatment of choledochoceles", Clin Gastroenterol Hepatol, 12, pp.196~203 (2014)
- Yamaguchi M, "Congenital choledochal cyst. Analysis of 1,433patients in the Japanese literature", Am J Surg, 140, pp.653~657 (1980)
- Kim JH, "Four cases of choledochocele diagnosed by endoscopic retrograde cholangio-pancreatography (ERCP) and treated with endoscopic sphincterotomy (EST)", Korean J Gastrointest Endosc, 17, pp.211~219 (1997)
- Chang TS, "Idiopathic dilatation of the common bile duct", Kyungpook Univ Med J, 7, pp.267~275 (1966)
- Venu RP, "Role of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of choledochocele", Gastroenterology, 87, pp.1144~1149 (1984)
- Sterling JA, "Diverticula in the terminal portion of the common bile duct", Am J Pathol, 25, pp.325~337 (1949)
- Scholz FJ, "The choledochocele: correlation of radiological, clinical and pathological findings", Radiology, 118, pp.25~28 (1976)
- Masetti R, "Choledochocele: changing trends in diagnosis and management", Surg Today, 26, pp.281~285 (1996)
- Yamaoka K, "Choledochocele with obstructive jaundice:a case report and a review of the Japanese literature", J Gastroenterol, 29, pp.661~664 (1994)
- Ohtsuka T, "Carcinoma arising in choledochocele", Endoscopy, 33, pp.614~619 (2001)
- Bismuth H, "Choledochal cystic malignancies", Ann Oncol, 10(Suppl 4), pp.94~98 (1999)
- Horaguchi J, "Clinical study of choledochocele: is it a risk factor for biliary malignancies?", J Gastroenterol, 40, pp.396~401 (2005)
- Sacher VY, "Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: case series and review", World J Radiol, 5, pp.304~312 (2013)
- Avunduk C, "Obstructing choledochocele:diagnosis by endoscopic ultrasound", Abdom Imaging, 20, pp.72~74 (1995)
- 안혁수, "혈액 답즙증을 유발한 담낭암 1예", Clinical Endoscopy, 27(3), pp.171~174 (2003), 대한소화기내시경학회
- Finch PJ, "Duodenal pseudotumour:a silent impacted common bile duct calculus", Postgrad Med J, 65, pp.794~796 (1989)
- Berger A, "Endoscopic management of a large choledochocele associated with choledocholithiasis", Gastroenterol Clin Biol, 31, pp.200~203 (2007)
- Schimpl G, "Choledochocele:importance of histological evaluation", J Pediatr Surg, 28, pp.1562~1565 (1993)