抄録
A 63year-old female complained of recurrent common bile duct stones. In her previous medical history, laparoscopic cholecystectomy was performed for cholecystolithiasis in 2001. Choledochoduodenostomy was also performed for recurrent biliary stones in 2009. However, the patient was admitted to the hospital repeatedly due to recurrent cholangitis associated with biliary stones. Although the biliary stones were completely retrieved by endoscopic interventions, cholangitis recurred a few months later. She was referred to our hospital where magnetic resonance cholangiopancreatography (MRCP) revealed a massive common bile duct stone with a diameter of 4 cm. Initially endoscopic retrograde cholangiopancreatography (ERCP) was undertaken to retrieve the stone and detected that the massive stone was compacted in the common bile duct. The result of stone component analysis showed that it was mostly composed of ursodeoxycholic acid (UDCA). UDCA administration was thought to be associated with her recurrent stone events and this therapy was thus ceased. During the two-year period since this time, there have been no recurrent episodes of cholangitis due to biliary stones.
