| Theme | Treatment of Choledocholithiasis | |
|---|---|---|
| Title | Endoscopic Management of Common Bile Duct Stones in Patients with Bleeding Tendency | |
| Publish Date | 2017/01 | |
| Author | Seiichi Hara | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center |
| Author | Naoki Okano | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center |
| Author | Ken Ito | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center |
| Author | Kensuke Takuma | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center |
| Author | Kensuke Yoshimoto | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center |
| Author | Yoshinori Igarashi | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center |
| [ Summary ] | The treatment of bile duct stones in patients with bleeding tendency is most important for decreasing the risk factor of bleeding. Some papers report that endoscopic papillary balloon dilation (EPBD) has a lower rate of bleeding and perforation than endoscopic sphincterotomy (EST). In a patient with hemorrhagic tendency, antithrombotic drugs (anticoagulant and antiplatelet drugs) are typically indicated. Other risk factors are acute obstructive suppurative cholangitis with disseminated intravascular (DIC), liver cirrhosis with the decreasing of coagulation factor and platelet count, the patient's blood dialysis with vulnerability of tissues and capillaries and long‒term oral taking of anti‒cancer drugs and steroids. In this paper, we explain endoscopic treatments of bile duct stones in patients with bleeding tendency. | |