Contact litholysis of common bile duct stones. Experience in 44 patients.

被引:0
|
作者
Takacs, T
Lonovics, J
CaroliBosc, FX
Montet, AM
Montet, JC
机构
[1] INSERM, LAB PHYSIOPATHOL HEPAT, F-13009 MARSEILLE, FRANCE
[2] ALBERT SZENT GYORGYI MED UNIV, DEPT MED 1, H-6701 SZEGED, HUNGARY
来源
GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE | 1997年 / 21卷 / 10期
关键词
stones; common bile duct; litholysis; contact solvents; endoscopic sphincterotomy;
D O I
暂无
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives. - Endoscopic sphincterotomy has become a generally accepted method for extracting common bile duct stones in high risk or cholecystectomized patients. However, stone extraction is impossible by the usual methods in 5 to 10 % of cases. The purpose of this study was to evaluate the effect of a recently developed solvent system in patients with large bile duct stones. Methods. - Forty four patients (15 men and 29 women, median age 61 years) underwent contact dissolution after unsuccessful Dormia extraction. Solvents were administered via a nasobiliary catheter in 41 patients following papillotomy and through a T-tube in 3 patients. Solvent mixtures (26 mM ethylene diamine tetraacetic acid, 40 mM sodium deoxycholate and 30 % dimethyl sulfoxide in an alkaline aqueous solution; and a 70/30 dimethyl sulfoxide/methyl tert-butyl ether mixture) were infused continuously and alternatively for 2 hours. Results. - Bile duct stones disappeared in 13-24 hours of infusion in 11 patients. In 29 patients, a clear reduction in stone volume occurred, allowing complete endoscopic extraction of the fragments. In 4 patients, the size of the stone did not change. Only mild and transient side-effects including abdominal pain (68 %), nausea (72 %), vomiting (52 %), diarrhea and sleepiness (50 %) were observed. Conclusion. - Direct dissolution therapy could be all effective method for the non-surgical management of large bile duct stones in selected patients when intra- or extracorporeal lithortripsy is unsuccessful.
引用
收藏
页码:655 / 659
页数:5
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