1986 Volume 28 Issue 3 Pages 589-594_1
Recently endoscopic coagulation with microwave system was devised for the treatment of gastrointestinal polypoid lesion, cancer and bleeding. We applied a new procedure of endoscopic duodeno-choledochal fistulization (EDCF) for a case with biliary obstruction due to choledocholithiasis. In this case, seventy-five years old female who had several episodes of abdominal discomfort, two choledochal stones (20×16 mm, 19×6 mm in diameter) were disclosed by ERCP examination. Serum total bilirubin level had been normal and biliary enzymes had increased remarkably. The coagulations with microwave system were done each time with 20 watt for 20 seconds, and were performed totaly 44 times. This therapeutics was safely achieved without any complication during and after the procedure. Successful discharge of two stones through the artifical fistula was demonstrated by ERCP 7 days after the procedure. The increased enzymes have returned to normal level within a week after discharge of the stones.
