| Theme |
Treatment of Choledocholithiasis |
| Title |
Common Bile Duct Stones Treatment in Cases with Surgically Altered Anatomy |
| Author |
Masataka Kikuyama |
Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital |
| Author |
Shinya Kawaguchi |
Department of Gastroenterology, Shizuoka General Hospital |
| Author |
Shuzou Terada |
Department of Gastroenterology, Shizuoka General Hospital |
| [ Summary ] |
Recently, endoscopic transpapillary treatments of common bile duct stones (CBDSs) have broadly been adapted to the cases with Billroth II reconstruction and Roux‒en‒Y reconstruction and gastrectomy patients, upon which a forward‒viewing endoscope and a balloon enteroscope were generally used, respectively. Moreover, usefulness of an oblique‒viewing endoscope has also been reported. Endoscopic papillary large‒balloon dilation added to conventional methods by using endoscopic sphincterotomy and endoscopic papillary balloon dilation has been accepted to remove CBDSs, upon which stone disappearance by biliary stent placement could be expected. Compared with usual cases, endoscopic transpapillary treatments of post‒gastrectomy patients with these reconstructions are more hazardous because of the a risk of intestinal perforation due to postoperative intestinal adhesion Hence, a therapeutic strategy including a percutaneous method should be considered. |