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How Should Biliary Stones be Managed?

심찬섭
거트앤리버 소화기연관학회협의회|2010.06|Gut and Liver|제4권 제2호|pp. 161-172

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초록

Minimally invasive therapy is currently invaluable for the treatment of biliary stones. Clinicians should be familiar with the various endoscopic modalities that have been evolving. I reviewed the treatment of biliary stones from the common practice to pioneering procedures,and here I also briefly summarize the results of many related studies. Lithotripsy involves procedures that fragment large stones, and they can be roughly classified into two groups: intracorporeal modalities and extracorporeal shock-wave lithotripsy (ESWL). Intracorporeal modalities are further divided into mechanical lithotripsy (ML), electrohydraulic lithotripsy,and laser lithotripsy. ESWL can break stones by focusing high-pressure shock-wave energy at a designated target point. Balloon dilation after minimal endoscopic sphincterotomy (EST) is effective for retrieving large biliary stones without the use of ML. Peroral cholangioscopy provides direct visualization of the bile duct and permits diagnostic procedures or therapeutic interventions. Biliary stenting below an impacted stone is sometimes worth considering as an alternative treatment in elderly patients. This article focuses on specialized issues such as lithotripsy rather than simple EST with stone removal in order to provide important information on state-of-the-art procedures.

Abstract

Minimally invasive therapy is currently invaluable for the treatment of biliary stones. Clinicians should be familiar with the various endoscopic modalities that have been evolving. I reviewed the treatment of biliary stones from the common practice to pioneering procedures,and here I also briefly summarize the results of many related studies. Lithotripsy involves procedures that fragment large stones, and they can be roughly classified into two groups: intracorporeal modalities and extracorporeal shock-wave lithotripsy (ESWL). Intracorporeal modalities are further divided into mechanical lithotripsy (ML), electrohydraulic lithotripsy,and laser lithotripsy. ESWL can break stones by focusing high-pressure shock-wave energy at a designated target point. Balloon dilation after minimal endoscopic sphincterotomy (EST) is effective for retrieving large biliary stones without the use of ML. Peroral cholangioscopy provides direct visualization of the bile duct and permits diagnostic procedures or therapeutic interventions. Biliary stenting below an impacted stone is sometimes worth considering as an alternative treatment in elderly patients. This article focuses on specialized issues such as lithotripsy rather than simple EST with stone removal in order to provide important information on state-of-the-art procedures.

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관련 논문AI추천

Recent advances in the management of difficult bile-duct stones: a focus on single-operator cholangioscopy-guided lithotripsy동석호, 오치혁대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제2호Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and EndosonographyHirofumi Kogure, Hiroyuki Isayama, Kazuhiko Koike, Kazunaga Ishigaki, Kei Saito, Minoru Tada, Naminatsu Takahara, Ryunosuke Hakuta, Suguru Mizuno, Tatsuya Sato, Tomotaka Saito, Tsuyoshi Hamada, Yousuke Nakai거트앤리버 소화기연관학회협의회 · Gut and Liver2020 · 제14권 제3호Cracking Difficult Biliary StonesPhonthep Angsuwatcharakon, Rungsun Rerknimitr대한소화기내시경학회 · Clinical Endoscopy2021 · 제54권 제5호Evolving Strategies for the Optimal Management of Common Bile Duct StonesChon Hyung Ku, Jo Ik Hyun, Park Chang Hwan거트앤리버 소화기연관학회협의회 · Gut and Liver2025 · 제19권 제5호Electrohydraulic Lithotripsy for Difficult Bile Duct Stones under Endoscopic Retrograde Cholangiopancreatography and Peroral Transluminal Cholangioscopy GuidanceAkira Miyano, Atsushi Okuda, Kazuhide Higuchi, Miyuki Imanishi, Nobu Nishioka, Rieko Kamiyama, Takeshi Ogura, Wataru Takagi거트앤리버 소화기연관학회협의회 · Gut and Liver2018 · 제12권 제4호Endoscopic Papillary Balloon Dilation for Removal of Choledocholithiasis: Indications, Advantages, Complications, and Long-Term Follow-Up Results정재복, Joo Won Chung거트앤리버 소화기연관학회협의회 · Gut and Liver2011 · 제5권 제1호

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