| Autor: |
Hanazaki, Kazuhiro, Sodeyama, Harutsugu, Asato, Susumu, Sode, Yoshihisa, Matsuda, Yoshiaki |
| Jazyk: |
angličtina |
| Rok vydání: |
1997 |
| Předmět: |
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| Zdroj: |
Acta medica et biologica. 45(3):127-132 |
| ISSN: |
0567-7734 |
| Popis: |
To determine the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in detecting retained stones or bile duct injury immediately after following laparoscopic cholecystectomy (LC), 113 patients were reviewed undergoing LC between September 1993 and September 1996. Among them, 44 patients (38.9%) underwent ERCP within postoperative day 4. ERCP was indicated as follows: 1) patients with postoperative cholestasis and/or excessive amounts of bilious drainage from the intraabdominal drain; 2) patients with discrepancies between preoperative imaging modalities and intraoperative findings; and 3) patients without either preoperative ERCP or intraoperative cholangiography (IOC). Postoperative complications detected by ERCP included bile duct injury in 2 patients, retained common bile duct (CBD) stone in 1 patient, and hepatolithiasis in 1 patient. One patient mistakenly clipped CBD not to a cystic duct, and subsequent ERCP showed interruption of the bile duct so that an emergency operation was performed. Another patient had leakage from a cystic duct-CBD junction, and subsequent ERCP showed abundant leakage of the bile duct, so that endoscopic nasobiliary drainage (ENBD) was performed. The retained CBD stone was removed by endoscopic sphincterotomy (EST) following ERCP. In conclusion, ERCP immediately following LC in the selected patients on the basis of the above indications of 1) and 2) may be recommended as one useful method which detects accurately retained stones and bile duct injury. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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