A CASE OF OBSTRUCTIVE JAUNDICE DUE TO LIMY BILE TREATED WITH ENDOSCOPIC PAPILLARY BALLOON DILATATION (EPBD) IN YOUNG PATIENT

Abstract

A 27-year-old woman consulted our hospital with epigastric pain. Since obstructive jaundice caused by limy bile in the common bile duct was diagnosed based on blood tests and imaging studies, emergency endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic balloon dilatation (EBD) were performed to remove limy bile and stones in the common bile duct. The drainage was assumed effective, because a massive volume of limy bile flowed from the common bile duct ; however, jaundice was exacerbated due to EBD stent obstruction on the following day, Endoscopic papillary balloon dilatation (EPBD) and lithotripsy were carried out. Endoscopic nasobiliary drainage (ENBD) was performed after removal of the common bile duct stones. The limy bile was subsequently removed completely from the common bile duct. After improvement of the jaundice, laparoscopic cholecystectomy was performed for the gallstones. EPBD and lithotripsy were effective for obstructive jaundice due to limy bile in a young patient.