Endoscopic stenting of bile ducts for preventing mechanical jaundice recurrence in gallstone migration-Reference-Cited by-同舟云学术

Endoscopic stenting of bile ducts for preventing mechanical jaundice recurrence in gallstone migration

Published:2023-09-21 Issue:3 Volume:28 Page:65-74
ISSN:2408-9524
Container-title:Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery
language:
Short-container-title:Ann. hir. gepatol.

Author:

Kotovskiy A. E.¹^ORCID,Glebov K. G.²^ORCID,Magomedova B. M.³^ORCID,Onnicev I. E.⁴^ORCID,Hokonov M. A.⁵^ORCID,Prividentseva A. S.⁵^ORCID,Mahmudova A. K.⁵^ORCID,Milyushkova T. M.⁵^ORCID,Pershin V. V.⁵^ORCID,Hokonov A. M.⁵^ORCID

Affiliation:

1. I.M. Sechenov First Moscow State Medical University (Sechenov University)

2. Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation; Filatov City Clinical Hospital No.15

3. Demihov City Clinical Hospital

4. The Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation; A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation

5. Filatov City Clinical Hospital No.15

Abstract

Aim. To study the reasons for stone migration from the gallbladder into the main bile ducts after endoscopic lithoextraction and to develop methods for preventing recurrent mechanical jaundice before performing the cholecystectomy.Material and methods. Delayed cholecystectomy was recommended for 328 patients with calculous cholecystitis and mechanical jaundice after endoscopic papillosphincterotomy, lithoextraction and restoration of adequate bile outflow. 23 patients were readmitted to hospital with recurrent mechanical jaundice caused by recurrent choledocholithiasis. All patients underwent duodenoscopy, endoscopic retrograde cholangiography and lithoextraction within 12 hours after admission. The size of the gallstones, the diameter of the cystic duct, the level of its insertion into the common hepatic duct, and the length of the previously performed papillotomy were considered as possible causes of recurrent choledocholithiasis.Results. Multiple gallstones of 2–4 mm and low cystic duct insertion into the common hepatic duct were detected in all 23 patients. An increase in the diameter of the cystic duct >5 mm was revealed in 18 patients. In 10 patients, the initial papillotomy was <8 mm.Conclusion. The factors predisposing to recurrent mechanical jaundice due to migration of gallstones into the bile duct and indications for its stenting after lithoextraction before cholecystectomy are ultrasound signs of multiple small gallstones, low insertion the dilated cystic duct into the bile duct, and partial, non-extended papillotomy.

Publisher

Annals of Surgical Hepatology

Subject

Gastroenterology,Hepatology,Surgery

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