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Volume 7 (1993)
- Issue 5 Pages 555-
- Issue 4 Pages 445-
- Issue 3 Pages 271-
- Issue 2 Pages 99-
- Issue 1 Pages 17-
Volume 7, Issue 1
Displaying 1-9 of 9 articles from this issue
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[in Japanese]1993 Volume 7 Issue 1 Pages 17-21
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSDownload PDF (899K) -
1993 Volume 7 Issue 1 Pages 22-42
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSDownload PDF (5552K) -
Hideo YAMAMOTO, Yuji NIMURA, Naokazu HAYAKAWA, Junichi KAMIYA, Satoshi ...1993 Volume 7 Issue 1 Pages 43-50
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSPercutaneous transhepatic biliary endoprosthesis under PTCS has been developed for malignant biliary obstruction for which fluoroscopic placement of endoprosthesis could not be performed. From 1981 through 1990, endoprosthesis under PTCS was applied in 44 cases of malignant bile duct stricture, consisting 33 cases of unresctable carcinoma of the pancreas or the bile duct and 11 biliary strictures due to recurrent cancer. At first, the biliary stenosis is observed under PTCS and a guidewire is introduced through the stricture to the distal bile duct. Internal biliary drainage was accomplished by clamping the proximal end of the external and internal drainage catheter of silicone or polyuretane. It was also established by placing a T-tube in the hepatic hilus. Endoprosthesis could be performed in 89% of the 44 cases. Internal biliary drainage was succeeded in 26 cases (67%), and 21 (80%) of them discharged our hospital. Clogging of the catheter or cholangitis has not been observed in 12 patients (43%). Percutaneous cholangioscopic endoprosthesis has many advantages over endoscopic retrograde biliary drainage in preventing ascending cholangitis, maintaining internal biliary drainage for a long period and obtaining a good quality of life and survival.View full abstractDownload PDF (2949K) -
Toshio TSUYUGUCHI, Hiromitsu SAISHO1993 Volume 7 Issue 1 Pages 51-62
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSHepatolithiasis has been a challenging condition in the treatment. Peroral cholangioscopy could have a potentiality favorable to the less invasive treatment of hepatolithiasis, because the access to bile ducts, usually through the duodenal papilla, is always ready when once available.
We performed peroral cholangioscopic lithotripsy in 23 patients with intrahepatic st o nes. For stone fragmentation under the direct vision of the cholangioscope, an electrohydraulic pressure was applied in 16 patients, a Nd: YAG laser in one and a flashlamp-pumped dye laser in one.
Intrahepatic stones were smashed when the cholangioscope was accessible. Total clearance of intrahepatic bile ducts was achieved in 14 patients, partial clearance in 7. The two failures had a severe stricture in the bile duct which did not allow the instrument to pass. There were no remarkable complications; in only one case minor hemobilia occurred during electrohydraulic pressure lithotripsy. All successful patients were well without biliary complaints during the follow up period of three to 55 months after the procedure had completed.
Peroral cholangioscopic lithotripsy should be a safe and effective method in the treatment of intrahepatic stones.View full abstractDownload PDF (3627K) -
Satoshi TAMAKI, Yutaka TAKAESU, Yoshihiro MUTO, Toshiomi KUSANO, Kanea ...1993 Volume 7 Issue 1 Pages 63-67
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSAn absorbable clip used for ligation of the cystic duct stump migratedinto the intrahepatic bil duct was detected on postoperative cholangioscopy in the case who had had laparoscopic coledocholithotripsy with T-tube drainage. This rare complication has prompted us to describe the present case.
A 68-year-old female patient had presented with recurrent episodes of right upper quadrant pain and spiked fever since August 1991. She was referred to the Ryukyu University Hospital for further examination on March 1992. She was diagnosed to have common duct stones and bilateral intrahepatic biliary strictures. Laparoscopic choledocholithotripsy with T-tube drainage was carried out. Postoperative T-tube cholangiography demonstrated bile leakage from the Ttube inserted common duct. One week after cholangiography, cholangioscopic examination through T-tube fistula disclosed an absorbable clip applied to the cystic duct stump in the intrahepatic bile duct. It was successfully extracted by postoperative cholangioscopy.
The authors believe that the clip was slipped away fro m the cystic duct stump due to inflammation of the cystic duct stump, resulted its migration into the intrahepatic bile duct through the leakage hole of the common duct around T-tube.View full abstractDownload PDF (4063K) -
Mikihiro YOKOTE, Kou NISHIKAWA, Michiko YOKOTE, Hajime TAKIKAWA, Kazuh ...1993 Volume 7 Issue 1 Pages 68-72
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSWe reported a case of cholecystitis which was considered as a polyp of the gallbladder on diagnostic imaging, with the review of a literature. A 65-year-old male was admitted to our hospital because of the right upper abdominal pain. Ultrasonography showed a papillary polypoid lesion at the body of the gallbladder as well as whole wall thickening of the gallbladder. The polyp was maximum 35 mm in diameter and did not change in the shape after the therapy for cholecystitits, highly suspectious for a cancer. Histological examination of the surgical specimen revealed cholecystitis with granuloma and cholesterosis without any evidence of malignancy.View full abstractDownload PDF (2483K) -
Minoru KATO, Toshiyuki HATTORI, Yoji KOJIMA, Shigeki YAMAGISH, Saburo ...1993 Volume 7 Issue 1 Pages 73-79
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSA 41-year-old female under treatment for diabetes mellitus was admitted to our hospital because of right upper quadrant pain and fever. After diagnosis of acute cholecystitis with a gall stone by ultrasonography (US), we treated her with antibiotics, however the abdominal pain and fever continued. US and computed tomography (CT) showed a large lesion in the left hepatic lobe, covering the spleen. After diagnosis of a liver abscess with intraperitoneal perforation, we performed percutaneous transhepatic abscess drainage (PTAD). Her general condition improved immediately after PTAD, so 15 days after PTAD the drainage catheter was removed. Barium meal study and endoscopic retrograde cholangiopancreatography (ERCP) showed cholecystoduodeneal fistula, but 14 days after PTAD CT showed the gall stone moving through the duodenum, so no operation was performed. The patient has reported no complaints after discharge.View full abstractDownload PDF (3381K) -
Yuji NAGAI, Takafumi YAMASHITA, Hiroji NISHINO, Satoshi TAKATSUKA, Tam ...1993 Volume 7 Issue 1 Pages 80-87
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSA 77-year-old woman was admitted to our hospital complaining of jaundice in 1992.
She was pointed out cholelithiasis in 1980, but didn't have any therapy because of no symptom. On admission she had hyperbilirubinemia (19.0 mg/dl) and US showed moderate dilatation of the intra- and extrahepatic bile duct. We performed PTCD and found much mucinous discharge from the PTCD tube. She had also stones of the gallbladder and the common bile duct. CT and EUS showed tumorous thickness of the wall of the gallbladder and no abnormal findings of the pancreas. We suspected mucin-producing carcinoma of the gallbladder and performed cholecystectomy, partial resection of the common bile duct and lymphnodes dissection. Papillomatous tumor with mucin was occupied at the neck of the gallbladder and histologically it was mucinous adenocarcinoma with invasion to proper muscle of the gallbladder.
There are a few reports of mucin-producing carcinoma of the gallbladder with obstructive jaundice.View full abstractDownload PDF (3854K) -
Mitsugi SHIMODA, Takashi TAJIMA, Shinji OKA, Atsushi IGARASHI, Kunibum ...1993 Volume 7 Issue 1 Pages 88-92
Published: February 25, 1993
Released on J-STAGE: November 13, 2012
JOURNAL FREE ACCESSA 63-year-old male with no history of previous operation was admitted on June 11,1990due to jaundice of two weeks' duration. Serum total bilirubin on admission was 17 mg/dl and PTCD was immediately carried out. PTC and ERCP revealed approximately 8 mm incomplete membranous stricture at the middle of the bile duct. In spite of one month's conservative treatment, there appeared no sign of improvement of the stricturre. With the diagnosis of nonmalignant stricture of the bile duct, operation was performed on July 23. On lapalotomy, a thumbtip size induration was palpable at the middle of the bile duct with no malignant findings Cholecystectomy and resection of the bile duct with hepaticojejunostomy were carried out. Histologically, nonspecific inflammatory changes and findings similar to amputation neuroma at the stricture site were obtained.
It seems that s u ch case has never been reported here to fore in the world literature.View full abstractDownload PDF (5206K)
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