Endoscopic Removal of a Bile-Duct Stone Using Sphincterotomy and a Large-Balloon Dilator in a Patient with Situs Inversus Totalis
0
조회
0
다운로드
1
인용
0
참고문헌
초록
45-year-old female with known situs inversus totalis presented with colicky pain in the left upper abdominal quadrant. The laboratory parameters showed elevated neutrophils and a bilirubin level of 2 mg/dL. CT confirmed situs inversus totalis and dilatation of the intra- and extrahepatic ducts with a 10-mm common bile duct (CBD) stone and a 10-mm gallstone. She underwent papillary dilatation using a radial expansion balloon after sphincterotomy, after which the CBD stone was removed with a basket and balloon. There were no complications, such as bleeding, pancreatitis,or perforation. It might be reasonable to attempt a “partial” biliary endoscopic sphincterotomy followed by a large-balloon dilator in patients with concomitant distal bile duct, papillary stenosis, or altered anatomy (e.g., periampullary diverticulum, Billroth II anatomy). However, when performing an “adequate” biliary endoscopic sphincterotomy this is technically difficult, or in some cases even impossible, and is associated with a higher risk of complications. This paper further expands on the application of these techniques and shows that a papillary balloon dilatation after endoscopic sphincterotomy is a safe, easy, and effective technique for removing bile-duct stones in a patient with situs inversus totalis.
Abstract
45-year-old female with known situs inversus totalis presented with colicky pain in the left upper abdominal quadrant. The laboratory parameters showed elevated neutrophils and a bilirubin level of 2 mg/dL. CT confirmed situs inversus totalis and dilatation of the intra- and extrahepatic ducts with a 10-mm common bile duct (CBD) stone and a 10-mm gallstone. She underwent papillary dilatation using a radial expansion balloon after sphincterotomy, after which the CBD stone was removed with a basket and balloon. There were no complications, such as bleeding, pancreatitis,or perforation. It might be reasonable to attempt a “partial” biliary endoscopic sphincterotomy followed by a large-balloon dilator in patients with concomitant distal bile duct, papillary stenosis, or altered anatomy (e.g., periampullary diverticulum, Billroth II anatomy). However, when performing an “adequate” biliary endoscopic sphincterotomy this is technically difficult, or in some cases even impossible, and is associated with a higher risk of complications. This paper further expands on the application of these techniques and shows that a papillary balloon dilatation after endoscopic sphincterotomy is a safe, easy, and effective technique for removing bile-duct stones in a patient with situs inversus totalis.
참고문헌 (17)
- "Gastrointestinal: situs inversus viscerum", J Gastroenterol Hepatol, 17, pp.1329~ (2002)
- Binmoeller KF, "Endoscopic management of bile duct stones", J Clin Gastroenterol, 32, pp.106~118 (2001)
- Misra SP, "Large-diameter balloon dilation after endoscopic sphincterotomy for removal of difficult bile duct stones", Endoscopy, 40, pp.209~213 (2008)
- Maydeo A, "Balloon sphincteroplasty for removing difficult bile duct stones", Endoscopy, 39, pp.958~961 (2007)
- Heo JH, "Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones", Gastrointest Endosc, 66, pp.720~726 (2007)
- Attasaranya S, "Balloon dilation of the papilla after sphincterotomy: rescue therapy for difficult bile duct stones", Endoscopy, 39, pp.1023~1025 (2007)
- Ersoz G, "Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract", Gastrointest Endosc, 57, pp.156~159 (2003)
- Minami A, "Small sphincterotomy combined with papillary dilation with large balloon permits retrieval of large stones without mechanical lithotripsy", World J Gastroenterol, 13, pp.2179~2182 (2007)
- Bergman JJ, "A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy", Gastrointest Endosc, 53, pp.19~26 (2001)
- Kim GH, "Endoscopic removal of bile-duct stones by using a rotatable papillotome and a large-balloon dilator in patients with a Billroth II gastrectomy (with video)", Gastrointest Endosc, 67, pp.1134~1138 (2008)
- Mugica F, "Selective sphincteroplasty of the papilla in cases at risk due to atypical anatomy", World J Gastroenterol, 13, pp.3106~3111 (2007)
- Yoo B, "Large balloon sphincteroplasty along with or without sphincterotomy in patients with large extrahepatic bile duct stones: multi center study", Gastrointest Endosc, 65, pp.AB97~ (2007)
- Attasaranya S, "Large-diameter papillary balloon dilation to aid in endoscopic bile duct stone removal: a multicenter series", Gastrointest Endosc, 65, pp.AB214~ (2007)
- Espinel J, "Large hydrostatic balloon for choledocolithiasis", Rev Esp Enferm Dig, 99, pp.33~38 (2007)
- Pathak KA, "Situs inversus with cholelithiasis", J Postgrad Med, 41, pp.45~46 (1995)
- Sherman S, "Endoscopic sphincterotomy-induced hemorrhage: treatment with multipolar electrocoagulation", Gastrointest Endosc, 38, pp.123~126 (1992)
- Gholson CF, "Delayed hemorrhage following endoscopic retrograde sphincterotomy for choledocholithiasis", Dig Dis Sci, 41, pp.831~834 (1996)