scholarly journals Percutaneous Transhepatic Cholangioscopy and Stone Extraction in a Patient with Recurrent Cholangitis Following Liver Trauma

2021 ◽  
Vol 11 ◽  
pp. 11
Author(s):  
Lee K. Rousslang ◽  
Omar Faruque ◽  
Kyler Kozacek ◽  
J. Matthew Meadows
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Stone Formation ◽  
Gallstone Pancreatitis ◽  
Stone Extraction ◽  
Biliary Stones ◽  
Interventional Radiologist ◽  
Biliary Stone ◽  
First Case ◽  
Percutaneous Transhepatic Cholangioscopy

Percutaneous transhepatic cholangioscopy (PTCS) is a safe and effective treatment for obstructive biliary stones, when endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful or unavailable. Once percutaneous access is gained into the biliary tree by an interventional radiologist, the biliary ducts can be directly visualized and any biliary stones can be managed with lithotripsy, mechanical fragmentation, and/or percutaneous extraction. We report a case of a 45-year-old man who sustained a traumatic liver laceration and associated bile duct injury, complicated by bile duct ectasia and intrahepatic biliary stone formation. Despite undergoing a cholecystectomy, multiple ERCPs, and percutaneous transhepatic cholangiogram with drain placement, the underlying problem was not corrected leading to recurrent bouts of gallstone pancreatitis and cholangitis. He was ultimately referred to an interventional radiologist who extracted the impacted intrahepatic biliary stones that were thought to be causing his recurrent infections through cholangioscopy. This is the first case of PTCS with biliary stone extraction in the setting of recurrent biliary obstruction and cholangitis due to traumatic bile duct injury.

scholarly journals Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

2018 ◽  
Vol 12 (3) ◽  
pp. 686-691 ◽  
Author(s):  
Anne M. Schreuder ◽  
Thomas M. van Gulik ◽  
Erik A.J. Rauws
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Stone Formation ◽  
Rare Complication ◽  
Arterial Embolization ◽  
Stone Extraction ◽  
Pseudo Aneurysm ◽  
The Common ◽  
The Right ◽  
And Function

Clips inserted during laparoscopic cholecystectomy (LC) may migrate into the biliary system and function as a nidus for the formation of gallstones. Here, we present a series of 4 patients who presented with this rare complication 5–17 years after LC. All 4 patients presented with symptomatic choledocholithiasis with biochemical and radiological signs of biliary obstruction. Three patients also had fever and infectious parameters, compatible with concurrent cholangitis. All patients successfully underwent endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy and stone extraction. Patients with cholangitis also had antibiotic treatment. In 3 patients, obstruction of the common bile duct was caused by a single, relatively large stone that had formed around a clip (supposedly the cystic duct clip). In 1 patient, multiple stones had formed around an intrabiliary migrated cluster of coils that had been used for arterial embolization of a pseudo-aneurysm of the right hepatic artery. In conclusion, surgical clips and coils can migrate into the biliary tract and serve as a nidus for the formation of bile duct stones. Although rare, this complication should caution surgeons not to place clips “at random” during cholecystectomy. Patients with this rare complication are best managed by ERCP in combination with sphincterotomy and stone extraction.

scholarly journals Closing common bile duct after laparoscopic cholecystectomy and biliary stone extraction combined flexible fiberoptic choledochoscope

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Trọng Hiền Dương ◽  
Trung Nghĩa Nguyễn
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Leak ◽  
Site Infection ◽  
Bile Duct Stones ◽  
Stone Extraction ◽  
Effective Technique ◽  
Biliary Stone

Tóm tắt Đặt vấn đề: Nghiên cứu nhằm đánh giá kết quả sớm điều trị bệnh nhân sỏi túi mật và ống mật chủ (OMC) được phẫu thuật nội soi (PTNS) kết hợp kiểm soát OMC (KS-OMC) bằng nội soi ống mềm tại Bệnh viện HN Việt Đức. Phương pháp nghiên cứu: 12 bệnh nhân (Nam/Nữ: 5/7) được khâu kín OMC sau PTNS cắt túi mật và lấy sỏi OMC có dùng nội soi đường mật ống mềm. Kết quả: Thời gian phẫu thuật trung bình: 145 ± 45 phút, lượng máu mất 70 ± 50ml (Lượng máu mất từ: 50ml tới 150 ml); các biến chứng trong mổ: không, biến chứng rò mật sau mổ: không, biến chứng nhiễm trùng vết mổ: 1 trường hợp; thời gian nằm viện trung bình 8 ± 1,5 ngày (Thời gian từ: 6 tới 10 ngày) Kết luận: Khâu kín OMC sau phẫu thuật nội soi cắt túi mật và lấy sỏi OMC có kiểm tra bằng nội soi đường mật ống mềm là an toàn và hiệu quả. Abstract Introduction: The objectives of study were to evaluate the early result of treatment patients with concomitant gallbladder stones and common bile duct (CBD) stones by laparoscopic surgery in using flexible fiberoptic choledochoscope. Material and Methods: There were 12 patients enrolled (male/female: 5/7) who are sutured bile duct after laparoscopic cholecystectomy and removing stones in common bile duct with cholangioscopy. Results: Average surgery time: 145 ± 45 min, blood loss 70 ± 50 ml, no postoperative complications related to the procedure. There is no bile leak. There is one surgical site infection, mean hospital stay of 8 ± 1,5 days (6 to 10 days). Conclusion: The current study suggests that laparoscopic surgery and using cholangioscopy to controlling bile duct for the management of cholecysto-choledocholithiasis is a safe and effective technique. Keywords: Gallstones, bile duct stones.

Percutaneous Management of Biliary Stones

2021 ◽  
Vol 38 (03) ◽  
pp. 348-355
Author(s):  
Nevzat Ozcan ◽  
Ahsun Riaz ◽  
Guven Kahriman
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Duct Stone ◽  
Stone Formation ◽  
Common Bile Duct Stones ◽  
Percutaneous Treatment ◽  
Stone Disease ◽  
Bile Duct Stones ◽  
Biliary Stones ◽  
Common Causes

AbstractBile duct stone disease is the most common causes of nonmalignant bile duct obstructions. The range of common bile duct stone formation in patients with cholecystectomy is 3 to 14.7%. Hepatolithiasis, although endemic in some parts of the world, is a rare disease that is difficult to manage. Endoscopic intervention is accepted as the first-line management of common bile duct stones. However, when the bile duct cannot be cannulated for various reasons, the endoscopic procedure fails. In this circumstance, percutaneous approach is an alternative technique for the nonsurgical treatment of bile duct stones. This article reviews the indications, technique, outcomes, and complications of the percutaneous treatment of bile duct stone disease.

scholarly journals Biliary stone extraction through T-tube tract using flexible fiberoptic choledochoscope

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Quan Anh Tuấn Lê
Keyword(s):  
Clearance Rate ◽  
Fiber Optic ◽  
Biliary Strictures ◽  
Stone Extraction ◽  
Biliary Stones ◽  
Biliary Stone ◽  
T Tube ◽  
Electrohydraulic Lithotripsy ◽  
Flexible Fiber ◽  
The Mean

Tóm tắt Đặt vấn đề: Còn sỏi sau mổ sỏi đường mật là một vấn đề thường gặp và là một vấn đề khó khăn đối với các phẫu thuật viên gan mật. Mục tiêu: Đánh giá hiệu quả của lấy sỏi mật qua đường hầm ống Kehr với ống soi mềm, kết hợp tán sỏi điện thủy lực. Phương pháp nghiên cứu: Nghiên cứu can thiệp, tiến cứu, không nhóm chứng. Chúng tôi sử dụng ống soi mềm đường mật 5mm, kết hợp với tán sỏi điện thủy lực. Kết quả: Từ tháng 01 năm 2010 đến tháng 01 năm 2013, chúng tôi thực hiện trên 164 bệnh nhân. Tuổi trung bình là 50. Tất cả các trường hợp (TH) đều có sỏi trong gan. Trong đó có 63 bệnh nhân có sỏi ống mật chủ kèm theo. Số lần lấy sỏi trung bình là 4,5 lần (từ 1 đến 10 lần). Có 139 TH (84,8%) phải tán sỏi điện thủy lực vì sỏi to hay dính chặt vào đường mật. Tỉ lệ hết sỏi sau khi lấy qua đường hầm ống Kehr trên cả 3 phương tiện bao gồm nội soi đường mật, siêu âm và X quang sau mổ là 90,9%. Nguyên nhân không lấy hết sỏi do đường mật nhỏ, gập góc hay có hẹp đường mật. Tỉ lệ hẹp đường mật là 34,8% (57 TH). Không có tai biến và biến chứng nặng. Thời gian nằm viện trung bình là 10 ngày. Kết luận: Lấy sỏi mật qua đường hầm ống Kehr kết hợp với tán sỏi điện thủy lực là cách giải quyết sỏi sót và sỏi đường mật trong gan rất hiệu quả và an toàn với tỉ lệ hết sỏi cao và không có biến chứng nặng. Đây là phương pháp tối ưu cho những bệnh nhân còn sỏi sau mổ có mang ống Kehr. Abstract Introduction: Retained biliary stones remain a common clinical problem in patients after surgery and a challenge for hepatobiliary surgeons. Objectives: The aim of this study is to evaluate the efficacy of biliary stone extraction via T-tube tract using a flexible fiber optic choledochoscope and electrohydraulic lithotripsy. Material and Methods: This is a prospective, interventional case series study. A 5mm flexible fiber optic choledochoscope was used in accompanied with electrohydraulic lithotripsy. Results: From January 2010 to January 2013, there were 164 included in this study. The mean age was 50. All of the patients had intrahepatic stones. Among them, 63 patients had common bile duct stones. Stone extractions on average were 4.5 (from 1 to 10 times). Electrohydraulic lithotripsy was necessary in 139 patients (84.8%) because of large or impacted stones. Complete clearance rate was 90.9% consisting of cholagioscopic, ultrasonographic and cholangioghaphic clearances. The most common factors related to failure of stone extraction are small associated with angulated intrahepatic bile ducts and biliary strictures. Biliary strictures were noticed in 57 patients (34.8%). There were no major accidents and complications. The mean hospital stay was 10 days. Conclusion: Biliary stone extraction via T-tube tract with electrohydraulic lithotripsy is a safe and efficient procedure for retained biliary stones and intra-hepatic stones with a high complete clearance rate and no major complications. This is the method of choice for treatment of retained biliary stones in patients with a T-tube in situ. Keywords: Biliary stone extraction, T tube tract.

scholarly journals Percutaneous Endoscopic Management for Oriental Cholangiohepatitis: A Case Report and a Brief Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Khalil Aloreidi ◽  
Prince Sethi ◽  
Terry Yeager ◽  
Muslim Atiq
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Bile Duct ◽  
Stone Formation ◽  
Acute Cholangitis ◽  
Biliary Tree ◽  
Endoscopic Management ◽  
Review Of The Literature ◽  
Biliary Stones ◽  
Intrahepatic Stones

Oriental cholangiohepatitis (OCH) is a disease characterized by intrabiliary pigment stone formation, resulting in recurrent bouts of cholangitis. OCH is found mostly in Southeast Asia but it is occasionally recognized in Western societies. OCH etiology is largely unknown. We report our experience with a patient who presented with acute cholecystitis. Following laparoscopic cholecystectomy, she developed acute cholangitis due to multiple biliary tree stones. She underwent ERCP to clear the stones from common bile duct. For the intrahepatic stones, she underwent novel hybrid percutaneous endoscopic technique. The procedure resulted in complete clearance of biliary tree stones and resolution of her symptoms. The aim of this case is to increase awareness of this disease when patients from endemic areas present with biliary stones.

Sign in / Sign up

Export Citation Format

Share Document