TECHNIQUE FOR TREATMENT OF BILE-DUCT STONES IN POST-GASTRECTOMY PATIENTS

概要

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Bile-duct stones have got to be considered as indication for endoscopic treatment in accordance with the accumulation of cases and advancement of endoscopy in patients with Billroth II or having undergone a Roux-en-Y gastrectomy. Introducing an endoscope into the duodenum and cannulating the bile duct with a catheter are responsible for achievement of the treatment, which depends on the type of endoscopy selected. A forward-viewing endoscope with a transparent hood or an oblique-viewing endoscopy is thought to be suitable for the treatment in patients with Billroth II. A balloon enteroscopy or an oblique-viewing endoscopy with an overtube can contribute to the achievement of success in Roux-en-Y patients. The skill of introducing an endoscope into the afferent loop, passing the Treitz ligament, and cannulating the bile duct with a catheter are necessary for the treatment of bile-duct stones.