Transhepatic balloon sphincteroplasty for bile duct stones after total gastrectomy.
Publication in refereed journal


Full Text

Times Cited

Other information
AbstractPrevious upper gastrointestinal surgery with the construction of a Roux-en-Y jejunal loop may prevent endoscopic access to the second part of the duodenum. We report a technique of percutaneous transhepatic balloon sphincteroplasty to facilitate the removal of common bile duct (CBD) stones. A 67-year-old woman presented with a 1-week history of right upper quadrant abdominal pain and fever, deranged liver function tests, and dilated intrahepatic ducts. The patient had previously had a total gastrectomy with Roux-en-Y reconstruction for a high-grade B-cell lymphoma of the stomach. Peroral endoscopic access to the biliary tree was unsuccessful. Percutaneous transhepatic cholangiography confirmed the presence of CBD stones. Over a period of 8 weeks, sequential dilatation of the percutaneous tract was undertaken. After a further 2 weeks, percutaneous choledochoscopy was performed. Several large stones were visualized and then fragmented. The choledochoscope would not pass through to the duodenum due to postinflammatory stenosis of the papilla, so the papilla was dilated with an endoscopic balloon. The remaining fragments were pushed through, and the duct was thoroughly irrigated with saline. Repeat cholangiography confirmed a clear CBD. Balloon catheter sphincteroplasty and biliary stone extrusion into the duodenum is a novel technique that enabled clearance of the CBD in an elderly patient who may otherwise have required open surgical exploration.
All Author(s) ListGalloway S.W., Chan A.C., Chung S.C.
Journal nameSurgical Endoscopy
Year2000
Month10
Day1
Volume Number14
Issue Number10
PublisherSpringer Verlag
Place of PublicationGermany
Pages966
ISSN0930-2794
eISSN1432-2218
LanguagesEnglish-United Kingdom

Last updated on 2020-25-10 at 01:33