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Chang HY, Wang CJ, Liu B, Wang YZ, Wang WJ, Wang W, Li D, Li YL. Ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of common bile duct stones. World J Gastroenterol 2018; 24:4489-4498. [PMID: 30356997 PMCID: PMC6196333 DOI: 10.3748/wjg.v24.i39.4489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 08/29/2018] [Accepted: 10/05/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct (CBD) stones.
METHODS From April 2014 to May 2016, 15 consecutive patients (6 men and 9 women) aged 45-86 (mean, 69.07 ± 9.91) years suffering from CBD stones associated with gallstones were evaluated. Good gallbladder contraction function was confirmed by type B ultrasonography. Dilation of the CBD and cystic duct was detected. Percutaneous transhepatic balloon dilation of the papilla was performed, ursodeoxycholic acid was administered, and all patients had a high-fat diet. All subjects underwent repeated cholangiography, and percutaneous transhepatic removal was carried out in patients with secondary CBD stones originating from the gallbladder.
RESULTS All patients underwent percutaneous transhepatic balloon dilation with a primary success rate of 100%. The combined therapy was successful in 86.7% of patients with concomitant CBD stones and gallstones. No remaining stones were detected in the gallbladder. Transient adverse events include abdominal pain (n = 1), abdominal distension (n = 1), and fever (n = 1). Complications were treated successfully via nonsurgical management without long-term complications. No procedure-related mortality occurred.
CONCLUSION For patients with concomitant CBD stones and gallstones, after percutaneous transhepatic removal of primary CBD stones, oral ursodeoxycholic acid and a high-fat diet followed by percutaneous transhepatic removal of secondary CBD stones appear to be a feasible and effective option for management of gallstones.
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Affiliation(s)
- Hai-Yang Chang
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
| | - Chang-Jun Wang
- Department of Radiology, Jiyang People’s Hospital, Jinan 251400, Shandong Province, China
| | - Bin Liu
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
| | - Yong-Zheng Wang
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
| | - Wu-Jie Wang
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
| | - Wei Wang
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
| | - Dong Li
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
| | - Yu-Liang Li
- Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
- Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
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