UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 胆道鏡検査および膵管鏡検査 cholangioscopy and pancreatoscopy
2. 胆管および膵管結石の治療における電気水圧砕石術 electrohydraulic lithotripsy in the treatment of bile and pancreatic duct stones
3. 胆石治療のためのレーザー砕石術 laser lithotripsy for the treatment of gallstones
4. 再発性化膿性胆管炎 recurrent pyogenic cholangitis
5. 膵胆管系の管腔内超音波検査 intraductal ultrasound of the pancreaticobiliary ductal system

English Journal

Predictive value of cholangioscopy after endoscopic management of early postcholecystectomy bile duct strictures with an increasing number of plastic stents: a prospective study (with videos).

Canena J1, Liberato M2, Coutinho AP1, Marques I3, Romão C3, Veiga PM4, Neves BC3.Author information 1Department of Gastroenterology, Pulido Valente Hospital, Faculty of Medical Sciences - Nova Medical School, Lisbon, Portugal; Center of Gastroenterology, Cuf Infanto Santo Hospital, Faculty of Medical Sciences - Nova Medical School, Lisbon, Portugal.2Center of Gastroenterology, Cuf Infanto Santo Hospital, Faculty of Medical Sciences - Nova Medical School, Lisbon, Portugal.3Department of Gastroenterology, Pulido Valente Hospital, Faculty of Medical Sciences - Nova Medical School, Lisbon, Portugal.4Curva de Gauss, Research, Training and Consulting, Canas de Senhorim, Portugal.AbstractBACKGROUND: Endotherapy of postcholecystectomy bile duct stricture (PCBS) has been established as an alternative treatment to surgery. Several studies have reported conflicting results regarding the predictors of success or failure of endotherapy.
Gastrointestinal endoscopy.Gastrointest Endosc.2014 Feb;79(2):279-88. doi: 10.1016/j.gie.2013.07.022. Epub 2013 Sep 5.
BACKGROUND: Endotherapy of postcholecystectomy bile duct stricture (PCBS) has been established as an alternative treatment to surgery. Several studies have reported conflicting results regarding the predictors of success or failure of endotherapy.OBJECTIVE: To evaluate the different cholangioscopic
PMID 24012251

Percutaneous Cholangioscopic Lithotripsy for Afferent Loop Syndrome Caused by Enterolith Development after Roux-en-Y Hepaticojejunostomy: A Case Report.

Kim SH, Jeong S, Lee DH, Yoo SS, Lee KY.Author information Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.AbstractAfferent loop obstruction caused by enterolith formation is rare and cannot be easily treated with endoscopy because of the difficulty associated with the nonsurgical removal of enteroliths. A 74-year-old woman was admitted with fever and acute abdominal pain. Clinical features and imaging studies suggested afferent loop obstruction caused by an enterolith after Roux-en-Y hepaticojejunostomy. Percutaneous transhepatic biliary drainage was initially performed because of severe cholangitis with septic shock. The enterolith was located in the jejunal limb adjacent to the hepaticojejunostomy site. Cholangioscopic lithotripsy was performed through the percutaneous transhepatic route to the enterolith, and the fragments were moved into the efferent loop using scope push and saline flush methods. Here, we describe a case of afferent loop syndrome caused by an enterolith that developed after Roux-en-Y hepaticojejunostomy and was treated with percutaneous transhepatic cholangio-enteroscopic lithotripsy.
Clinical endoscopy.Clin Endosc.2013 Nov;46(6):679-82. doi: 10.5946/ce.2013.46.6.679. Epub 2013 Nov 19.
Afferent loop obstruction caused by enterolith formation is rare and cannot be easily treated with endoscopy because of the difficulty associated with the nonsurgical removal of enteroliths. A 74-year-old woman was admitted with fever and acute abdominal pain. Clinical features and imaging studies s
PMID 24340266

Risk factors for long-term outcomes after initial treatment in hepatolithiasis.

Park JS, Jeong S, Lee DH, Bang BW, Lee JI, Lee JW, Kwon KS, Kim HK, Shin YW, Kim YS, Park SG.Author information Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.AbstractHepatobiliary complications, such as stone recurrence, recurrent cholangitis, liver abscess, secondary biliary cirrhosis, and cholangiocarcinoma may occur after treatment for hepatolithiasis. However, few previous studies have addressed the risk factors and long-term outcomes after initial treatment. Eighty-five patients with newly diagnosed hepatolithiasis, actively treated for hepatolithiasis, constituted the cohort of this retrospective study. Patients were treated by hepatectomy or nonoperative percutaneous transhepatic cholangioscopic lithotomy. Long-term complications, such as recurrent cholangitis, liver abscess, secondary biliary cirrhosis, and cholangiocarcinoma, and their relationships with clinical parameters were analyzed. The mean follow-up period was 57.4 months. The overall hepatobiliary complication rate after the treatment was 17.6%. Multivariate analysis of suspected risk factors showed that complications were associated with age (HR, 1.046; CI, 1.006-1.089), bile duct stricture (HR, 4.894; CI, 1.295-18.495), and residual stones (HR, 3.482; CI, 1.214-9.981). In conclusion, several long-term hepatobiliary complications occur after hepatolithiasis treatment, and regular observation is necessary in patients with concomitant biliary stricture or residual stones.
Journal of Korean medical science.J Korean Med Sci.2013 Nov;28(11):1627-31. doi: 10.3346/jkms.2013.28.11.1627. Epub 2013 Oct 31.
Hepatobiliary complications, such as stone recurrence, recurrent cholangitis, liver abscess, secondary biliary cirrhosis, and cholangiocarcinoma may occur after treatment for hepatolithiasis. However, few previous studies have addressed the risk factors and long-term outcomes after initial treatment
PMID 24265526

Japanese Journal

ヨードアレルギーを有する胆道疾患診断治療におけるガドリニウム造影剤（ガドペンテト酸ジメグルミン）の使用経験

夏目まこと,佐野仁,福定繁紀,加地謙太,井上匡央,安部快紀,西江裕忠,西祐二,吉村至広,水島隆史,奥村文浩,宮部勝之,内藤格,林香月,中沢貴宏
Nippon Shokakibyo Gakkai Zasshi 110(5), 825-832, 2013
ヨードアレルギーを有する患者では胆道疾患の診断治療にヨード造影剤を使用できず，診療に難渋する．今回，MRI用造影剤であるガドペンテト酸ジメグルミンを肝内外結石，総胆管結石，胆管癌による閉塞性黄疸などの胆道疾患患者3例の診断および治療，術後のドレーン造影に対して使用し，良好な画像診断が可能であった．ガドリニウム造影剤はヨードアレルギーを有する患者における代替造影薬剤として有用と思われた．
NAID 130003364372