• Clinical Endoscopy
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• 제56권6호
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• pp.795-801
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• 2023

Background/Aims: Endoscopic biliary drainage is the gold standard treatment for cholangitis. The two methods of biliary drainage are endoscopic biliary stenting and nasobiliary drainage. A novel integrated outside biliary stent and nasobiliary drainage catheter system (UMIDAS NB stent; Olympus Medical Systems) was recently developed. In this study, we evaluated the efficacy of this stent in the treatment of cholangitis caused by common bile duct stones or distal bile duct strictures. Methods: We conducted a retrospective pilot study by examining the medical records of patients who required endoscopic biliary drainage for cholangitis due to common bile duct stones or distal bile duct strictures, and who were treated with a UMIDAS NB stent, between December 2021 and July 2022. Results: Records of 54 consecutive patients were reviewed. Technical and clinical success rates were 47/54 (87.0%) and 52/54 (96.3%), respectively. Adverse events were observed in 12 patients, with six patients experiencing pancreatitis as an adverse event, following endoscopic retrograde cholangiopancreatography (ERCP). Regarding late adverse events, five cases of biliary stent migration into the bile duct were observed. Disease-related death occurred in one patient. Conclusions: The outside-type UMIDAS NB stent is an efficacious new method for biliary drainage and can be applied to many indications.

• Clinical Endoscopy
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• 제57권2호
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• pp.263-267
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• 2024

Technical failure of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is often attributed to device failure. To rectify this problem, we developed a single-pigtail plastic stent (SPPS) for EUS-GBD. We retrospectively reviewed the cases of four patients who underwent EUS-GBD for acute cholecystitis. To prepare the SPPS, a 7.5-Fr endoscopic nasobiliary drainage tube was cut to an appropriate length. The use of SPPS during EUS-GBD was successful from both technical and clinical standpoints. The SPPS spontaneously detached 57 days after the procedure in patient 4 and 412 days after the procedure in patient 1. Patient 1 developed cholecystitis after 426 days and was managed with antibiotics. The other three patients did not develop any complications after surgery. In conclusion, we designed a new SPPS dedicated to EUS-GBD and established its technical feasibility and clinical effectiveness.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제1권1호
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• pp.144-147
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• 1998

저자들은 복부 둔상 후에 발생한 담도 단독 협착을 보인 환아에서 수술적인 치료를 대신하여 내시경적 경비담도 배액술과 플라스틱 스텐트 삽입으로 증상의 호전과 2년의 추적관찰에서 재발을 보이지 않고 있는 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

• 대한방사선기술학회지:방사선기술과학
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• 제20권1호
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• pp.43-49
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• 1997

Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

• 대한방사선기술학회지:방사선기술과학
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• 제28권2호
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• pp.105-110
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• 2005

담관 결석은 동통뿐만 아니라 황달이나 담도염 또는 췌장염 등을 유발할 수 있다. 결석에 대한 내시경적 제거가 실패할 경우 체외충격파쇄석술이 요구될 수 있는데, 이 논문은 담관 결석환자에 대한 체외충격파쇄석술 적용에 있어 보다 더 적절한 선택 기준을 정하는데 도움을 주기 위함이다. 총담관 결석 환자 중 기계적 쇄석술을 포함한 내시경적 제거에 실패한 46명이 체외충격파쇄석술을 받았다. 46명 모두 체외충격파쇄석술 전에 내시경적 유두괄약근 절개술을 받았으며, 경비담도배액관의 삽입이 이루어 졌다. 사용된 쇄석기는 초음파 유도하에 결석을 포착하는 시스템으로 spark-gap type이였다. 쇄석 후 추가적인 내시경적 제거술이 이루어 졌으며, 결석이 완전 제거된 경우는 89.1%(41/46)였으며, 자연 배출된 경우는 6.5%였다. 쇄석 후 결석제거율은 결석의 수(단일: 82.8%, 둘-셋: 100%, 넷 이상: 100%)와 크기(33 mm 미만: 92.9%, 33 mm 이상: 83.3%)에서는 큰 차이가 없었으나, 결석들의 장축 길이 합과 결석이 위치하지 않는 부분의 총담관 길이 합을 비교하였을 때 완전 제거된 경우와 그렇지 않은 경우의 비가 1:1.4와 1:1.1, 그리고 가장 큰 결석의 직경과 결석하방의 총담관 직경을 비교한 경우는 그 비가 1:0.9와 1:0.4로 의미 있는 차이를 보였다. 결론적으로, 결석의 수나 크기보다는 총담관 내에 분쇄된 결석이 충분히 움직여 바스켓으로 포획될 수 있는 공간이 있을 경우에 체외충격파쇄석술 적용이 상당히 유용하나 그렇지 않은 경우는 경피적 담도경을 이용한 제거가 유용할 것으로 보인다.