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題名 | Clinical Experience with Endoscopic Stents for Treatment of Common Bile Duct Stones=以內視鏡支架治療總膽管結石的臨床經驗 |
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作者 | 陳瑞灝; 楊國卿; 劉玉華; 徐以信; 王建民; 孫灼基; 朱光恩; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 98:2 1999.02[民88.02] |
頁次 | 頁128-132 |
分類號 | 415.456 |
關鍵詞 | 內視鏡支架; 總膽管結石; Stent; Common bile duct; Bile stone; Endoscopic sphincterotomy; |
語文 | 英文(English) |
英文摘要 | Endoscopic removal of common bile duct (CBD) stones after endoscopic sphincterotomy (EST) is now a widely accepted procedure. Surgery is usually recommended when extraction of stones after EST fails. For patients with major medical problems or who are at high surgical risk, however, endoscopic stent placement may help to prevent stone impaction and cholangitis. In this report, we describe the longterm effects and complications of biliary stent use in elderly patients with CBD stones. From August 1995 to June 1998, 19 patients with CBD stones underwent stent placement by duodenoscopy. Three of these patients underwent this procedure for temporary treatment while awaiting surgery or EST. In the remaining 16 patients (6 men and 10 women, mean age 76 ± 10 years), invasive management carried a high risk of complications. We used a 7F straight stent for the first patient, while the remaining 15 received 7F pigtail stents. During a mean follow-up oeriod of 34 months, two patients were lost to follow-up and two patients had migration of the stents. Three patients had acute cholangitis with stents in situ. Of these, one underwent stent exchange 8 months later, while the CBD stones were cleared either by endoscopy or surgery in the other two patients. Five patients died of nonbiliary diseases during the follow-up period. Our results show that long-term biliary stent placement is an advisable alternative therapeutic modality for high-risk and debilitated patients with CBD stones. |
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