Abstract
There are recently various approaches for the treatment of common bile duct stones (CBDS) including open surgery, laparoscopic surgery, and endoscopic procedures.
In our institution, we usually perform endoscopic papillary balloon dilation (EPBD) with precut sphincterotomy (preEST) for CBDS more than 1 cm in diameter as our policy.
From November in 1996 to August in 2000, we treated 44 cases with CBDS by EPBD and 45 cases by EPBD combined with preEST. The average period of observation was 23.6 months. Recurrent CBDS were observed in 3 cases. Two cases were the patients who retained the gallbladder (GB) with stones after EPBD. The cystic ducts were slightly dilated and the gallbladders were not visualized at the initial cholangiography in these cases. This finding suggests that GB stones could be easy to move to CBD after EPBD in the patients with so-called negative GB at the initial cholangiography. Rest of one case underwent laparoscopic cholecystectomy after EPBD combined with EST, however, recurrent CBDS was observed one year and 9 months later. This patient had received hemodialysis for chronic renal failure. Although there are controversial opinions on the prevalence rate of cholelithiasis in patients undergoing dialysis, it is suggested that we need to take care of these patients carefully for the reccurence of CBDS.
