Kimura K, Kudo K, Yoshizumi T, Kurihara T, Yoshiya S, Mano Y, Takeishi K, Itoh S, Harada N, Ikegami T, Ikeda T. Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone: A case report. World J Clin Cases 2019; 7(10): 1149-1154 [PMID: 31183346 DOI: 10.12998/wjcc.v7.i10.1149]
Corresponding Author of This Article
Koichi Kimura, MD, PhD, Assistant Professor, Doctor, Surgeon, Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, 2-15-1, Tamura, Sawaraku, Fukuoka 814-0175, Japan. kkimura@surg2.med.kyushu-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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Kimura K, Kudo K, Yoshizumi T, Kurihara T, Yoshiya S, Mano Y, Takeishi K, Itoh S, Harada N, Ikegami T, Ikeda T. Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone: A case report. World J Clin Cases 2019; 7(10): 1149-1154 [PMID: 31183346 DOI: 10.12998/wjcc.v7.i10.1149]
Koichi Kimura, Kensuke Kudo, Tetsuo Ikeda, Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, Fukuoka 814-0175, Japan
Koichi Kimura, Kensuke Kudo, Tomoharu Yoshizumi, Takeshi Kurihara, Shohei Yoshiya, Yohei Mano, Kazuki Takeishi, Shinji Itoh, Noboru Harada, Toru Ikegami, Tetsuo Ikeda, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Author contributions: Kimura K was responsible for the study conception, design and drafting of the manuscript; Kudo K, Kurihara T, Yoshiya S, Mano Y, Takeishi K, Itoh S, Harada N, and Ikegami T were responsible for data collection; Yoshizumi T and Ikeda T were responsible for critical revision of the manuscript, and all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Koichi Kimura, MD, PhD, Assistant Professor, Doctor, Surgeon, Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, 2-15-1, Tamura, Sawaraku, Fukuoka 814-0175, Japan. kkimura@surg2.med.kyushu-u.ac.jp
Telephone: +81-92-8010411 Fax: +81-92-8010459
Received: February 12, 2019 Peer-review started: February 13, 2019 First decision: March 9, 2019 Revised: March 20, 2019 Accepted: March 26, 2019 Article in press: March 26, 2019 Published online: May 26, 2019 Processing time: 105 Days and 0.4 Hours
Abstract
BACKGROUND
In patients with large stones in the common bile duct (CBD), advanced treatment modalities are generally needed. Here, we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy (EHL) by the percutaneous approach and rendezvous endoscopic retrograde cholangiography (ERC) using a nasal endoscope.
CASE SUMMARY
A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm. She was referred to our institution after the failure of lithotomy by ERC, and after undergoing percutaneous transhepatic biliary drainage. We attempted to fragment the stone by transhepatic cholangioscopy using EHL. However, the stones were too large and partly soft clay-like for lithotripsy. Next, we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy. No complication was observed at the end of this procedure.
CONCLUSION
Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.
Core tip: Common bile duct (CBD) stones that are very large may require choledochotomy or lithotomy. However, surgery may be contra indicated in very elderly patients, and alternate treatments are required. Recent reports indicate that electrohydraulic lithotripsy (EHL) is an effective treatment for bile duct stones. We used EHL, followed by retrograde cholangiography and the rendezvous technique via nasal endoscope to successfully treat an elderly patient with a 50 mm diameter CBD stone.
