论文部分内容阅读
SUMMARY.In this paper we evaluated the frequency,consequences of,and therapeuticapproach to fragment migration after percutaneous treatment of gallstones.Fragment migra-tion occurred in 10(17 %)of 58 patients undergoing either percutaneous contact dissolutionor mechanical stone removal,Fragments impacted in the cystic duct in five patients,whilefragments passed into the common bile duct(CBD)in six patients(one patient had both si-multaneously),Cystic duct fragments were symptomatic in four of the five patients;threepatients were symptomatic at the time of fragment detection and were treated immediately(two with further contact dissolution and one by flushing the fragment from the cystic ductto the duodenum).CBD fragments were asymptomatic and passed spontaneously in four ofthe six patients.Two patients with CBD fragments had endoscopic retrograde cholangio-graphy and sphincterrotomy to remove fragments,as they were unwilling to await possiblespontaneous passage of fragments.
SUMMARY. This paper we evaluated the frequency, consequences of, and therapeuticapproach to fragment migration after percutaneous treatment of gallstones. Fragment migra tion occurred in 10 (17%) of 58 patients undergoing either percutaneous contact dissolutionor mechanical stone removal, Fragments impacted in the cystic duct in five patients, whilefragments passed into the common bile duct (CBD) in six patients (one patient had both si-multaneously), Cystic duct fragments were symptomatic in four of the five patients; three patients were symptomatic at the time of fragment detection and were treated immediately (two with further contact dissolution and one by flushing the fragment from the cystic ductto the duodenum) .CBD fragments were asymptomatic and passed spontaneously in four of the six patients. Two patients with CBD fragments had endoscopic retrograde cholangio-graphy and sphincterrotomy to remove fragments, as they were unwilling to await possiblespontaneous passage of fragments.