Common Bile Duct Web Associated with Difficult Common Bile Duct Stone: Report of a Case

總膽管膜合併困難性總膽管結石：一病例報告

鄭吉良(Chi-Liang Cheng) ； 劉乃仁(Nai-Jen Liu) ； 洪建福(Chien-Fu Hung) ； 游明晉(Ming-Chin Yu) ； 唐端祥(Jui-Hsiang Tang)

《臺灣消化醫學雜誌》 25卷2期 (2008/06) Pp. 199-203

https://doi.org/10.6557/GJT.200806_25(2).0007

摘要

總膽管出現網狀物阻塞相當罕見。我們在此報告一位51歲因膽囊結石合併肝功能異常，於接受內視鏡逆行性膽胰管攝影檢查時，發現遠端總膽管出現膜狀物阻塞，造成近端膽管擴大，並合併有一顆5公分大的總膽管結石。我們對該總膽管膜施予內視鏡擴張治療，治療後膽道出現自限性的出血。該大型困難性總膽管結石則在8個月的膽道支架置放術治療後，依舊無法以碎石器取出，最後患者選擇接受外科手術治療，術後順利出院，在整個治療過程中並無明顯併發症發生。

關鍵字

總膽管膜 ； 困難性總膽管結石

並列摘要

Webs in the common bile duct (CBD) are rare. This report describes a case of CBD web in association with gallstones and a large CBD stone (50 mm×26 mm) in a 51-year-old female. The diagnosis was made on endoscopic retrograde cholangiopancreatography (ERCP) and the web was dilated by controlled radial expansion balloon. Self-limited bleeding occurred after web dilatation. The large and difficult CBD stone was managed by periodical endoscopic biliary stenting, and two extraction attempts failed. The patient underwent uneventful open cholecystectomy and choledocholithotomy. This report reviews relevant cases reported in English; diagnostic and therapeutic aspects are discussed.

並列關鍵字

CBD web ； difficult CBD stone