Lithotripsy by shock wave was performed in 12 patients with choledocholithiasis using the authors' own apparatus. The shock wave is created by an electric spark and the concentration is made by a rotational semi-elipsoid. The pressures attained in the second focus are 150 MPa. The focusing of the stones and the setting to the site of maximal pressures is made by means of two X-ray projections. Patients were indicated for the procedure when the method of endoscopic extraction had failed. Before the procedure a nasobiliary drain was inserted and after administration of analgesia on average 520 shocks were applicated. During the procedure no complications were observed. Fragmentation was achieved in 11 patients. Spontaneous release of fragments was recorded in five of the patients and in 6 during the check-up ERCP endoscopic extraction was made.
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"Biliary-cast syndrome" ("BCS") is most often encountered in clinical practice as a complication after liver transplantation, there are also described cases of biliary-cast syndrome in patients who did not undergo liver transplantation, isolated cases of "BCS" developing in patients with acute pancreatitis, choledocholithiasis are described in literature. Ischemic damage to bile duct epithelium with development of cholestasis and retrograde biliary tract infection are considered as the main etiological factors. This work presents a clinical case of "Biliary-cast syndrome" in a patient with acute biliary pancreatitis and pulmonary embolism.
View Article and Find Full Text PDFWiad Lek
January 2025
SALISBURY NHS FOUNDATION TRUST, SALISBURY, UNITED KINGDOM.
Objective: Aim: To investigate the risk factors for PEP in patients with choledocholithiasis.
Patients And Methods: Materials and Methods: We have retrospectively analyzed 253 cases with choledocholithiasis that underwent ERCP. The primary endpoint was the occurrence of PEP.
World J Gastrointest Surg
January 2025
Department of Hepatobiliary Surgery, Affiliated Nantong Hospital Third of Nantong University, Nantong 226006, Jiangsu Province, China.
Background: Intraoperative and postoperative biliary injuries remain significant complications of laparoscopic common bile duct exploration (LCBDE). Indocyanine green (ICG) has been shown to significantly reduce injuries caused by intraoperative operational errors. We found that the J-tube can reduce postoperative strictures and injuries to the common bile duct.
View Article and Find Full Text PDFCureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFGastro Hep Adv
September 2024
Gastroenterology Division, Medicine Department, Prince Mohammed Bin Abdulaziz Hospital, Ministry National Guard - Health Affairs, Almadinah, Almunawwarah, KSA.
Situs inversus totalis is a rare congenital disorder defined by the transposition of all viscera to the opposite side of the body. Because of this anatomical alteration, endoscopic retrograde cholangiopancreatography (ERCP) in such a population is significantly challenging. Herein we report a case of a 50-year-old woman presented with epigastric and left upper quadrant pain.
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