Magnetic resonance virtual endoscopy of the common bile duct stones

1999 ◽  
Vol 13 (6) ◽  
pp. 632-633 ◽  
Author(s):  
E. Neri ◽  
D. Caramella ◽  
P. Boraschi ◽  
G. Braccini ◽  
E. D. Lehmann ◽  
...  
2019 ◽  
Vol 6 (6) ◽  
pp. 2002
Author(s):  
M. Valarmathi ◽  
Anandi Andappan

Background: Choledocholithiasis implies stones in the common bile duct (CBD). Most of the common bile duct stones are those that have passed into the bile duct from the gall bladder. About 20 to 25% of patients above the age of 60 with symptomatic gall stones are likely to have stones in the CBD. To analyse the role of ERCP and MRCP in the management of choledocholithiasis.Methods: About 60 patients who are attending the General Surgery OPD of Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India from the October 2017-March 2018 were included in the study with confirmed common bile duct stones with or without gall stones were chosen. patients were categorized into group A- who has undergone a successful ERCP followed by laparoscopic cholecystectomy and group B- who underwent open cholecystectomy with CBD exploration.Results: Ultrasonography was done in 57 patients, of which 41 patients showed CBD stones (71.93%), 12 patients showed dilated CBD in the presence of cholelithiasis (21.05%) and in the remaining 4 patients (7.01%) this investigation showed only cholelithiasis. Since clinical condition warranted, authors proceeded with further hepatobiliary imaging, which revealed choledocholithiasis.Conclusions: Magnetic resonance cholangio pancreatography can also be used for follow up of the patients with choledocholithiasis after therapy, to look for the presence of retained stones, since it can detect stones even in the size as small as 2 mm. Selective use of intraoperative choledochoscopy in suspected cases helps in reducing the incidence of retained stones.


2006 ◽  
Vol 13 (5) ◽  
pp. 398-402 ◽  
Author(s):  
Masato Yamazaki ◽  
Hideki Yasuda ◽  
Souichirou Tsukamoto ◽  
Yoshio Koide ◽  
Tsutomu Yarita ◽  
...  

2005 ◽  
Vol 71 (9) ◽  
pp. 750-753
Author(s):  
Gabriel Akopian ◽  
James Blitz ◽  
Thomas Vander Laan

The treatment of choledocholithiasis discovered incidentally during laparoscopic cholecystectomy is not yet standardized. Options include laparoscopic common bile duct exploration (LCBDE), postoperative endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy (ERCP-ES), and no intervention. We undertook a review of our case series to determine whether LCBDE is obligatory and which LCBDE method is unsuccessful. During the 6-year study period, 91 patients with choledocholithiasis were identified. Fifty-six patients (62%) underwent LCBDE. Thirteen (23%) of these 56 patients subsequently required ERCP. Balloon sweeping of the common bile duct failed in 10 of 21 patients (48% failure) compared to any other combination of techniques with a failure rate of 1/33 (3%; P < 0.001). Two patients did not undergo complete duct exploration because of technical problems. Thirty-five patients (38%) did not undergo LCBDE. Nine of these patients (26%) did not have ERCP-ES. None of the patients who underwent postoperative ERCP-ES required additional procedures or surgery. LCBDE can successfully treat common bile duct stones, with minimal to no morbidity, but is not mandatory for safely treating choledocholithiasis. Additionally, advanced techniques for clearing the common bile duct are more successful. Surgeons should be proficient at performing these techniques.


2000 ◽  
Vol 51 (4) ◽  
pp. AB306
Author(s):  
Atsushi Minami ◽  
Tatsuya Yamagami ◽  
Masaa Ngahama ◽  
Ryota Higuchi ◽  
Rikiya Fujita

2004 ◽  
Vol 28 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Guillaume Gautier ◽  
Frank Pilleul ◽  
Arielle Crombe-Ternamian ◽  
Laurent Gruner ◽  
Thierry Ponchon ◽  
...  

2005 ◽  
Vol 42 (4) ◽  
pp. 239-243 ◽  
Author(s):  
Marcus Vinicius Silva Ney ◽  
Fauze Maluf-Filho ◽  
Paulo Sakai ◽  
Bruno Zilberstein ◽  
Joaquim Gama-Rodrigues ◽  
...  

BACKGROUND: Endoscopic retrograde cholangiography is highly accurate in diagnosing choledocholithiasis, but it is the most invasive of the available methods. Endoscopic ultrasonography is a very accurate test for the diagnosis of choledocholithiasis with a risk of complications similar to that of upper gastrointestinal endoscopy. AIM: To compare the accuracy of endoscopic ultrassonography and endoscopic retrograde cholangiography in the diagnosis of common bile duct stones before laparoscopic cholecystectomy and to analyze endoscopic ultrasound results according to stone size and common bile duct diameter. PATIENTS AND METHODS: Two hundred and fifteen patients with symptomatic gallstones were admitted for laparoscopic cholecystectomy. Sixty-eight of them (31.7%) had a dilated common bile duct and/or hepatic biochemical parameter abnormalities. They were submitted to endoscopic ultrassonography and endoscopic retrograde cholangiography. Sphincterotomy and sweeping of the common bile duct were performed if endoscopic ultrassonography or endoscopic retrograde cholangiography were considered positive for choledocholithiasis. After sphincterotomy and common bile duct clearance the largest stone was retrieved for measurement. Endoscopic or surgical explorations of the common bile duct were considered the gold-standard methods for the diagnosis of choledocholithiasis. RESULTS: All 68 patients were submitted to laparoscopic cholecystectomy with intraoperative cholangiography with confirmation of the presence of gallstones. Endoscopic ultrassonography was a more sensitivity test than endoscopic retrograde cholangiography (97% vs. 67%) for the detection of choledocholithiasis. When stones >4.0 mm were analyzed, endoscopic ultrassonography and endoscopic retrograde cholangiography presented similar results (96% vs. 90%). Neither the size of the stone nor the common bile duct diameter had influence on endoscopic ultrasonographic performance. CONCLUSIONS: For a group of patients with an intermediate or moderate risk with respect to the likelihood of having common bile duct stones, endoscopic ultrassonography is a better test for the diagnosis of choledocholithiasis when compared to endoscopic retrograde cholangiography mainly for small-sized calculi.


2021 ◽  
pp. 43-47
Author(s):  
D. Riazanov ◽  
Yu. Mikheiev ◽  
O. Shpylenko

Summary. Purpose. To optimize the tactics of endoscopic interventions for cholelithiasis complicated by obstruction of the terminal portion of the common bile duct to reduce the incidence of postoperative complications and mortality in elderly and senile people. Materials and methods. The results of examination and treatment of 221 elderly and senile patients with cholelithiasis complicated by obstruction of the terminal section of the common bile duct were analyzed. Results. Using of existing methods and proposed new methods of endoscopic management of cholelithiasis complicated by obstruction of the terminal section of the common bile duct allow to reliably reduce the incidence of postoperative complications in elderly and senile patients from 19.8 to 9.5%, postoperative mortality from 10.3 to 2.9% Conclusions. In elderly and senile patients with obstruction of the terminal section of the common bile duct and common bile duct stones who bear high operational risk, endoscopic papillosphincterotomy with stone removal is a sufficient method of treatment. In case of unremovable common bile duct stones, endoscopic papillosphincterotomy and stenting allow to avoid revision of the common bile duct, and in high-risk patients those methods allow to refrain from open surgery.


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