간외담관결석에서 내시경적 유두괄약근 절개술후 담낭의 예후

Abstract

Background: Endoscopic sphincterotomy is used for the treatment of extrahepatic bile duct stone as a primary treatment nowadays. However the predictive factors of gallbladder complication after endoscopic bile duct stone clearance have not yet been defined. This study is conducted to evaluate the incidence and predictive factors of gallbladder complication after endoscopic sphincterotomy in patients with intact gallbladder. Method: We retrospectively reviwed the clinical records of 68 patients with intact gallbladder after endoscopic bile duct stone clearance from July 1987 to Oct. 1995. The patients have been followed up for 10-104 months(mean: 26.8 months). Results: The mean age of patients was 59.2 years old and the ratio of male to female was 1:1.6. Cholecystectomy was required in 5 patiens(7.4%) because of acute cholecystitis. Increased frequency of cholecystectomy was found in patients younger than 50 years. Other factors, such as gallbladder stone, opacification of gallbladder at endoscopic cholangiography, perivater diverticulum, common bile duct dilatation, and associated disease, were not related to gall bladder comlication after endoscopic sphincterotomy. Conclusion: The risk of development of gall bladder complication after endoscopic sphincterotomy for extrahepatic bile duct stone was higher in patients younger than 50 years. Further study may be needed for longer follow-up duration to recognize the risk factors which might be helpful when selectiong patients for subsequent cholecystectomy.