| Theme |
Current Treatment Strategies for Common Bile Duct Stones |
| Title |
Endoscopic Sphincterotomy for Removal of Bile Duct Stones in Billroth II Gastrectomy Patients |
| Author |
Yasuhide Ochi |
Second Department of Internal Medicine, Shinshu University School of Medicine |
| Author |
Hideaki Hamano |
Second Department of Internal Medicine, Shinshu University School of Medicine |
| Author |
Hiroshi Unno |
Second Department of Internal Medicine, Shinshu University School of Medicine |
| Author |
Hisanobu Saegusa |
Second Department of Internal Medicine, Shinshu University School of Medicine |
| Author |
Kendo Kiyosawa |
Second Department of Internal Medicine, Shinshu University School of Medicine |
| Author |
Taiji Akamatsu |
Department of Endoscopy, Shinshu University Hospital |
| Author |
Naoyuki Furuya |
Department of Internal Medicine, Hotaka Hospital |
| Author |
Hideharu Miyabayashi |
Nagano Prefectural Cancer Detection and Emergency Care Center |
| Author |
Kazunobu Miyata |
Department of Gastroenterology, Aizawa Hospital |
| [ Summary ] |
We assessed the safety and efficacy of needle-knife sphincterotomy (EST) guided by biliary endoprosthesis for removal of bile duct stones in Billroth II gastrectomy patients. In 58 out of 67 (86.6%) patients, who had been suspected of having bile duct stones, we successfully reached the papilla of Vater with the endoscope. Bile duct clearance was achieved in 35 out of 45 (77.8%) patients, for whom we had attempted stone extraction following EST. Complications occurred in seven patients. Two patients had perforations of the afferent loop when the endoscope was used. Five (13.5%) patients had early complications after EST. Three had retroperitoneal perforations of the duodenum and two had bleeding. Although special care is needed to prevent such complications, it is worthwhile to attempt this technique because stone removal is possible with various contrivances, even in patients with Billroth II gastrectomy. |