The clinical presentations of 20 patients with four or more choledochal stones were compared with those of 68 patients who had one to three choledochal stones, investigated during the same time period. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy. Patients with multiple choledochal stones usually presented with insidious onset of painless jaundice, simulating malignant bile duct obstruction, in contrast to the abrupt onset of cholangitis or pain experienced by patients with one to three stones. The latter patients had an increased number of duodenal diverticula, higher bilirubins, smaller stones, and fewer positive stones as detected by ultrasound of the bile ducts. Cholesterol crystals were more numerous in duodenal aspirates of patients with multiple choledochal stones. We conclude that multiple choledochal stones have a unique, more smoldering clinical presentation, and that ERCP is the diagnostic procedure of choice. Endoscopic sphincterotomy is an efficient, simple, and safe alternative to surgery when there is no cholecystitis.

Download full-text PDF

Source

Publication Analysis

Top Keywords

choledochal stones
20
multiple choledochal
12
stones
9
clinical presentations
8
bile duct
8
patients three
8
endoscopic sphincterotomy
8
patients multiple
8
patients
7
choledochal
5

Similar Publications

Background: Endoscopic retrograde cholangiopancreatography (ERCP) serves an essential role in treating biliary diseases, especially in choledocholithiasis. However, due to the limited human lifespan, there remains a paucity of clinical investigations on ERCP treatment in patients over 90 years old.

Aim: To explore the effectiveness and safety of ERCP in super-older patients aged ≥ 90 years with choledochal stones.

View Article and Find Full Text PDF

Background: Congenital biliary dilatation (CBD) is a congenital malformation of the main biliary tract usually associated with the pancreatobiliary maljunction (PBM), determining stone formation, cholangitis, pancreatitis, and cholangiocarcinoma. The role of endoscopic retrograde cholangiopancreatography (ERCP) in treatment and diagnosis has not been established yet. Therefore, the aim of our study is to define the actual role of ERCP in children with CBD.

View Article and Find Full Text PDF

Introduction: Duplication of the gallbladder is a rare congenital malformation associated with the development of cholelithiasis. It increases the risk of iatrogenic bile duct injury during cholecystectomy and can lead to symptom recurrence if missed. Although preoperative imaging is helpful, detection rates are around 50 %.

View Article and Find Full Text PDF
Article Synopsis
  • - The study evaluates surgical outcomes in children with type IV-A choledochal cysts (CDC), focusing on postoperative complications like strictures and intrahepatic stones, which have previously been associated with a poor prognosis.
  • - Researchers analyzed 76 patients who underwent laparoscopic cyst excision and biliary reconstruction, categorizing them based on whether their intrahepatic duct dilatation normalized within a year post-surgery.
  • - Follow-up results showed a high normalization rate of intrahepatic duct size (73.7% of patients) after an average recovery time of 1.65 months, with few complications; however, factors such as biliary sludge and the duct's maximum diameter were found to influence recovery outcomes.
View Article and Find Full Text PDF

Pancreaticobiliary maljunction (PBM) is a congenital anomaly where the pancreatic and bile ducts join outside the duodenal wall, resulting in formation of an elongated common channel. In normal physiology, the sphincter of Oddi regulates the junction between the pancreatic and bile ducts. Individuals with PBM lack this regulatory mechanism resulting in reflux of pancreatic juices into the biliary tract.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!