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01-03-2016 | Dynamic Manuscript

Effectiveness of peroral direct cholangioscopy using an ultraslim endoscope for the treatment of hepatolithiasis in patients with hepaticojejunostomy (with video)

Authors: Kazuyuki Matsumoto, Koichiro Tsutsumi, Hironari Kato, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto

Published in: Surgical Endoscopy | Issue 3/2016

Abstract

Background

Hepatolithiasis is a postoperative complication of hepaticojejunostomy (HJ) performed for various pancreatobiliary diseases. Hepatolithiasis can cause repeated cholangitis. Complete stone removal and bile stasis elimination are therefore necessary. Here, we evaluated the effectiveness of peroral direct cholangioscopy (PDCS) using an ultraslim endoscope for treating hepatolithiasis in HJ patients.

Methods

We studied 14 patients with hepatolithiasis who underwent bowel reconstruction with HJ between April 2012 and May 2014. Diagnostic and therapeutic endoscopic retrograde cholangiography using a short double-balloon enteroscope (DBE) was initially performed. Following stone removal, the DBE was exchanged for an ultraslim endoscope through the balloon overtube for PDCS.

Results

The success rate of PDCS procedure was 85.7 % (12/14). In 5 of 12 (41.7 %) patients with successful PDCS, the residual stones were detected and removed completely using a 5-Fr basket catheter and suction after normal saline irrigation. In the remaining 7 (58.3 %) patients, no residual stone was detected. The median procedure time was 14 min (range 8–36) with no serious postoperative complications. The median follow-up time after PDCS was 21 months (range 5–26), and only 1 patient (8.3 %) had IHBD stone recurrence with an anastomotic stricture.

Conclusions

PDCS using an ultraslim endoscope appears to be useful for detecting and removing residual stones following hepatolithiasis treatment using a DBE. The combined use of a DBE and PDCS may reduce the risk of hepatolithiasis recurrence in HJ patients.

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Title: Effectiveness of peroral direct cholangioscopy using an ultraslim endoscope for the treatment of hepatolithiasis in patients with hepaticojejunostomy (with video)
Authors: Kazuyuki Matsumoto
Koichiro Tsutsumi
Hironari Kato
Yutaka Akimoto
Daisuke Uchida
Takeshi Tomoda
Naoki Yamamoto
Yasuhiro Noma
Shigeru Horiguchi
Hiroyuki Okada
Kazuhide Yamamoto
Publication date: 01-03-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 3/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4323-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of peroral direct cholangioscopy using an ultraslim endoscope for the treatment of hepatolithiasis in patients with hepaticojejunostomy (with video)

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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