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내시경 유두괄약근 절개술과 큰 풍선 유두 확장술을 병용한 거대 담관결석의 치료

Other Titles
 Endoscopic Sphincterotomy Plus Endoscopic Papillary Large Balloon Dilatation for Large Bile Duct Stones 
 황성준  ;  김영균  ;  이규철  ;  지명관  ;  김현수  ;  백순구  ;  이근만  ;  장진혁  ;  김민수  ;  백용한  ;  이세준  ;  박효진  ;  이관식  ;  이상인  ;  이동기 
 Korean Journal of Gastrointestinal Endoscopy (대한소화기내시경학회지), Vol.32(3) : 184-189, 2006 
Journal Title
 Korean Journal of Gastrointestinal Endoscopy (대한소화기내시경학회지) 
Issue Date
Choledocholithiasis ; Endoscopic sphincterotomy ; Endoscopic papillary balloon dilatation
Background/Aims: The extraction of large common bile duct (CBD) stones after an endoscopic sphincterotomy (EST) is successful in 80∼90% of cases but it often requires a prolonged time and repeated trials. This study investigated the utility of a combined endoscopic papillary large balloon dilatation (EPLBD) and a mid-incision of an EST (m-EST) method for the removal of large CBD stones. Methods: Thirty patients with large CBD stones were enrolled in this study. EPLBD was carried out using the one-step inflation of a 15∼18 mm diameter balloon after m-EST. Results: The maximum stone diameter was 21.62±5.38 mm. Twelve patients had more than 4 stones, 7 patients had 2 stones, and the remainder had a single large stone. Complete ductal clearance was achieved in all patients. After the procedure, the serum amylase and/or lipase levels were elevated in 3 patients (13.3%). However, there was no episode of true pancreatitis. Minor bleeding was encountered in only one patient (3.3%), and was easily controlled by an endoscopic epinephrine injection. The procedure was carried out safely in 6 patients with periampullary diverticulum. No perforation or mortality was encountered. Conclusions: Combined EPLBD and m-EST is a safe and effective method, and may be a good alternative treatment for removing large CBD stones.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Paik, Yong Han(백용한)
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Lee, Sang In(이상인)
Lee, Se Joon(이세준) ORCID logo https://orcid.org/0000-0002-2695-2670
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