Abstract:Objective:To evaluate the method and effect of combination treatment with duodenoscope and choledochoscope for impacted residual bile duct stones.
Methods:From March 1998 to May 2010, 98 cases of residual bile duct stones, including 20 cases of postoperative acute severe cholangitis, 66 cases of postoperative choledocholithiasis and 12 cases of postoperative hepatolithiasis, were treated by combination of duodenoscope and choledochoscope, and the clinical data were retrospectively analyzed.
Results:The technique of combination of duodenoscope and choledochoscope was implemented successfully in all patients. In 95 of the 98 patients, stones were extracted successfully in the first session of combined treatment procedure(96.9%), and in 3 cases stones were extracted successfully in a second session(3.1%). The success rate of stone removal was 100%. The impacted stones of all patients were completely cleared without serious complications such as biliary tract perforation or hemorrhage. Acute pancreatitis occurred in 1 case(1.0%) and 9 cases had hyperamylasemia(9.2%) after the procedures.
Conclusions:The technique of combination of duodenoscope and choledochoscope for treatment of impacted residual bile duct stones is safe, effective, simple and minimally invasive, which is an ideal choice for treatment of impacted residual bile duct stones.