Refractory Bile Duct Stones Occurring at Hepaticoduodenostomy Site

Min Jeong Kim; Sang-Woo Cha; Young Deok Cho

doi:10.4166/kjg.2013.62.3.182

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Kim, Cha, and Cho: Refractory Bile Duct Stones Occurring at Hepaticoduodenostomy Site

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Korean J Gastroenterol 2013;62(3):182-184.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.3.182

Refractory Bile Duct Stones Occurring at Hepaticoduodenostomy Site

Min Jeong Kim, Sang-Woo Cha, Young Deok Cho

Digestive Disease Center, Department of Internal Medicine, Soonchunhyang Uinversity College of Medicine, Seoul, Korea

Correspondence to: Sang-Woo Cha, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang Uinversity College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul 140-743, Korea. Tel: +82-2-709-9494, Fax: +82-2-709-9696, E-mail: swcha@schmc.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

1. Garg PK, Tandon RK, Ahuja V, Makharia GK, Batra Y. Predictors of unsuccessful mechanical lithotripsy and endoscopic clearance of large bile duct stones. Gastrointest Endosc. 2004; 59:601–605.

2. Stefanidis G, Christodoulou C, Manolakopoulos S, Chuttani R. Endoscopic extraction of large common bile duct stones: A review article. World J Gastrointest Endosc. 2012; 4:167–179.

3. Arya N, Nelles SE, Haber GB, Kim YI, Kortan PK. Electrohydraulic lithotripsy in 111 patients: a safe and effective therapy for difficult bile duct stones. Am J Gastroenterol. 2004; 99:2330–2334.

4. Moon JH, Terheggen G, Choi HJ, Neuhaus H. Peroral cholangioscopy: diagnostic and therapeutic applications. Gastroenterology. 2013; 144:276–282.

5. Moon JH, Ko BM, Choi HJ, et al. Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos). Gastrointest Endosc. 2009; 70:297–302.

Fig. 1.

Computed tomography images show large stones (black arrow) in distal portion of hepaticoduodenostomy site with dilatation of both intrahepatic duct.

Fig. 2.

(A) Fluoroscopic image taken during endoscopic retrograde cholangiopancreatography demonstrates large bile duct stones at hepaticoduodenostomy site. (B) Duodenoscopic image shows impacted stone at the orifice of hepaticoduodenostomy site.

Fig. 3.

(A) Direct cholangioscope was inserted into the bile duct. (B) Electrohydraulic lithotripy probe is seen adjacent to the stone.

Fig. 4.

(A) Fluoroscopic image obtained during follow-up endoscopic retrograde cholangiopancreatography shows no residual filling defects in the bile duct. (B) Direct cholangioscope i-scan image shows red colored irregular intrahepatic bile duct mucosa.

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