유두부에 바스켓이 감돈된 총담관 결석의 체외충격파쇄석술 치험 1예

Abstract

Endoscopic sphincterotomy(EST) has become the treatment of choice for the patients with common bile duct(CBD) stones. The removal of stones usually requires extraction by a balloon or a Dormia basket. Occasionally after engagement of the stone, Dormia basket is impacted in the distal CBD and extraction of basket proves impossible. In this situation, emergency operation has been recommended but mechanical lithotrypsy or ESWL can be use for the altemative methods. We report the case of a 76-year-old man with CBD stone of 1.2 cm size. We tried stone removal using Dormia basket after EST. However, after engagement of stone with basket, the basket was impacted in the ampulla of Vater and was not moved forward or backward. We removed endoscope and ESWL was done targeting under fluoroscopy on the basket. After ESWL, the basket was spontaneosly placed in the stomach. In conclusion, ESWL can be helpful in the rare occasion of an impacted Dormia basket in the ampulla of Vater.