RISS 검색 - 국내학술지논문 상세보기

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다국어 초록 (Multilingual Abstract)

Aims: Common bile duct exploration (CBDE) is one of the available options in the management of choledocholithiasis. Most of the time we come across a single stone in common Bile Duct, rarely multiple stones and very rarely whole of the biliary system is loaded with stones. Endoscopic Retrograde Cholangiopancreaticography (ERCP) is a gold standard for the stone retrieval in most of cases. In our case report whole of the common bile duct, common hepatic duct, Right and left hepatic duct were loaded with multiple large size stones. Patient came to the hospital very late her biliary tract was very much thickened. ERCP was failed. So we had left only option of open common bile duct exploration. In case of multiple stones in whole of biliary duct system, open technique is the best option and may be the treatment of choice.
Methods: A 37 years old lady came in surgical outdoor with pain right side of abdomen. She was diagnosed as obstructed jaundice due to multiple gall bladder and whole of biliary tract stones. Obstruction was relieved by a stent by gastroenterologist. Unfortunately she visited the surgical outdoor clinic after one year due to various reasons. She underwent choledochotomy and all stones from biliary channels were removed. Because of delayed intervention, wall of the biliary channels were very much thick. Hypertrophic mucosa was very much appreciable. Wound was closed over a T-tube were for 2 weeks.
Results: Check cholangiogram was normal. Patient was discharge safely with regular follow up advice.
Conclusions: Management of stones in Hepatobiliary system is always a test case for the Hepatobiliary surgeon. It is straightforward if single but very much complex if they are multiple and extremely difficult if they involve entire Hepatobiliary channels. Open technique is best option in these cases right from the beginning.