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At least 649 records · Page 36Linked to original sources
PubMed1975

[Roentgeno-surgical comparisons in choledocholithiasis].

The results of roentgenological investigation of bile ducts are analysed in comparison with the revision findings during cholecystectomy and choledochotomy. Among 61 patients concretions were diagnosed in 37, and in 13 pa tients lethiasis of the ducts was suspected. In 6 observations no concretions were revealed, in 5 patients inadequate contrasting did not allow to judge the state of ducts. Emphasis is laid on the importance of infusion-drip administration of a contrast solution and simultaneous tomography of the ducts for the improved diagnosis of lithiasis.

Cholangiography↗
PubMed1992

[Therapy of choledocholithiasis using extracorporeal shock wave lithotripsy and adjuvant surgical endoscopy].

Extracorporeal shock wave lithotripsy of extra- and intrahepatic bile duct stones is indicated after failure of conventional operative endoscopic procedures including mechanical lithotripsy. An overview of the current literature (12 centers, 568 patients) indicates that this novel procedure has attracted international acceptance. It was applied in elderly patients (means = 65 years) with solitary (37.5%) or multiple (62.5%) concrements. Clearance of the bile ducts was achieved in 71.6% after 1.3 to 3.0 lithotripsy sessions (1900-4000 shocks) if additional endoscopic sphincterotomy was performed. Without sphincterotomy 61% of patients were treated successfully. The most frequent side effects were macrohematuria (6.9%), hemobilia (6.2%) cholangitis (4.5%) and pancreatitis (1.3%). A lethality of 0-3.6% (means = 0.6%) was reported. The current results demonstrate that therapy of extra- and intrahepatic bile duct stones with extracorporeal shock wave lithotripsy is effective, safe and provides high therapeutic comfort.

Aged↗
PubMed1992

[Is surgical bile duct revision in choledocholithiasis still indicated?].

Endoscopic papillotomy with stone extraction is increasingly performed for the management of common bile duct stones either before cholecystectomy or as a sole procedure leaving the gallbladder in situ. We have therefore evaluated the method of operative common duct exploration. 94 cases with bile duct stones treated by cholecystectomy and common bile duct exploration were reviewed. The 30-day mortality was 2.1% with an overall morbidity of 19%. A retained stone was found on postoperative T-tube cholangiography in 6 patients and in all cases was removed percutaneously via the T-tube track. Patients were divided into three age groups (less than or equal to 60, 61-75, greater than 75 years). In each patient various risk factors were recorded. Correlation was made between age, risk factors and patient's morbidity. No correlation was found between age and morbidity. Patients with up to two risk factors had a morbidity of 10%. With three to four risk factors the morbidity increased to 19%, reaching 47% in patients with five and more risk factors. Cholecystectomy with common bile duct exploration is a safe procedure even in the elderly patient. Careful evaluation of risk factors is necessary. Endoscopic papillotomy with or without cholecystectomy should be considered in high risk patients.

Adult↗
PubMed1991

[Laparoscopic placement of T-drainage in choledocholithiasis].

This case report illustrates the feasibility of bile duct revision and T-tube insertion by laparoscopic approach. The procedure largely employs the traditional action. Laparoscopy demands more skill, particularly regarding the suture of the common bile duct, but does not interfere its realisation.

Adult↗