胆石症
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2 brown pigment stone HMG-CoA reductase cholesterol alphahydroxylase, Caroli UDCA MDR UDCA UDCA Shoda J, He BF, Tanaka N, et al. Primary dual defect of cholesterol and bile acid metabolism in liver of patients with intrahepatic calculi. Gastroenterology ; 108 : - Shoda J, Oda K, Suzuki H, et al. Etiologic significance of defects in cholesterol, phospholipid, and bile acid metabolism in the liver of patients with intrahepatic calculi. Hepatology ; 33 : - Ros E, Navarro S, Bru C, et al. Ursodeoxycholic acid treatment of primary hepatolithiasis in Caroli s syndrome. Lancet ; 342 : - Rosmorduc O, Hermelin B, Poupon R. MDR gene defect in adults with symptomatic intrahepatic and gallbladder cholesterol cholelithiasis. Gastroenterology ; 120 : - 114
3 PTCS EHL. -,., 115
4 Child BC.,.. -.,, PTCS PTCS Huang MH, Chen CH, Yang JC, et al. Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis. Am J Gastroenterol ; 98 : - Lee SK, Seo DW, Myung SJ, et al. Percutaneous transhepatic cholangioscopic treatment for 116
5 hepatolithiasis : an evaluation of long-term results and risk factors for recurrence. Gastrointest Endosc ; 53 : - Chen SM, Cheng YF, Chen FC, et al. Ductal dilatation and stenting for residual hepatolithiasis : a promising treatment strategy. Gut ; 42 : - Yoshimoto H, Ikeda S, Tanaka M, et al. Choledochoscopic electrohydraulic lithotripsy and lithotomy for stones in the common bile duct, intrahepatic ducts, and gallbladder. Ann Surg ; 210 : - Mori T, Sugiyama M, Atomi Y. Gallstone disease : Management of intrahepatic stones. Baillieres Best Pract Res Clin Gastroenterol ; 20 : - 117
6 CT CEACA- 118
7 -, 119
8 ; 21 : - ; 95 : - Cheung MT, Kwok PC. Liver resection for intrahepatic stones. Arch Surg ; 140 : - Chen DW, Tung-Ping Poon R, Liu CL, et al. Immediate and long-term outcomes of hepatectomy for hepatolithiasis. Surgery ; 135 : - Vetrone G, Ercolani G, Grazi GL, et al. Surgical therapy for hepatolithiasis : a Western experience. J Am Coll Surg ; 202 : - ; 52 : - ; 60 : - Jeng KS, Ohta I, Yang FS. Reappraisal of the systematic management of complicated hepatolithiasis with bilateral intrahepatic biliary strictures. Arch Surg ; 131 : - ; 14 : - Uchiyama K, Onishi H, Tani M, et al. Indication and procedure for treatment of hepatolithiasis. Arch Surg ; 137 : - 120
9 Takada EST EST 121
10 PTCL, confluence stone ESTEMLPTCSPTCC- SLPTBDESWLEHL, Takada T, Uchiyama K, Yasuda H, et al. Indications for the choledochoscopic removal of intrahepatic stones based on the biliary anatomy. Am J Surg ; 171 : - Tanaka M, Ikeda S, Ogawa Y, et al. Divergent effects of endoscopic sphincterotomy on the long-term outcome of hepatolithiasis. Gastrointest Endosc ; 43 : - Prat F, Fritsch J, Choury AD, et al. Laser lithotripsy of difficult biliary stones. Gastrointest Endosc ; 40 : - Ikeda S, Tanaka M, Matsumoto S, et al. Endoscopic sphincterotomy : long-term results in patients with complete follow-up. Endoscopy ; 20 : - Fujita R, Yamamura M, Fujita Y. Combined endoscopic sphincterotomy and percutaneous transhepatic cholangioscopic lithotripsy. Gastrointest Endosc ; 34 : - Confluence stone Gastroenterol Endosc ; 43 : - 122
11 PTCS sump syndrome Rouxen Y Roux PTCS ESWL MDCT MRCP PTCS ESWL 123
12 ., PTCD Gazzaniga GM, Bondanza G, Filauro M, et al. Intrahepatic lithiasis above a bilio-digestive anastomosis. Hepatogastroenterology ; 40 : - Khan TF, Sherazi ZA, Muniandy S, et al. Recurrent pyogenic cholangitis : sump syndrome following choledochoduodenostomy. Trop Doct ; 27 : - ; 24 : - Chijiiwa K, Tanaka M. Late complications after excisional operation in patients with choledochal cyst. J Am Coll Surg ; 179 : - Saing H, Han H, Chan KL, et al. Early and late results of excision of choledochal cysts. J Pediatr Surg ; 32 : - ; 24 : - Shima H, Yamataka A, Yanai T, et al. Intracorporeal electrohydraulic lithotripsy for intrahepatic bile duct stone formation after choledochal cyst excision. Pediatr Surg Int ; 20 : - Ajiki T, Suzuki Y, Okazaki T, et al. A large stone detected in Roux-en-Y jejunal limb years after excision of congenital choledochal cyst. Surgery ; 139 : - 124
13 ; 33 : - Rieber A, Brambs HJ, Lauchart W. The radiological management of biliary complications following liver transplantation. Cardiovasc Intervent Radiol ; 19 : - 125
胆石症
ESWL ESWL LC QALE LC RCT cm 76 ESWL ESWL - - mm US X CT HU ESWL - ESWL ESWL UDCA, ESWL, UDCA, ESWL 77 Mirizzi - ; 90 : - Nicholl JP, Brazier JE, Milner PC, et al. Randomised controlled trial of cost-effectiveness
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RCT 128 - Sauter GH, Moussavian AC, Meyer G, et al. Bowel habits and bile acid malabsorption in the months after cholecystectomy. Am J Gastroenterol ; 97 : - ; 21 : - Arlow FL, Dekovich AA, Priest RJ,
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,. vs 64 .. vs. -, Ransohoff DF, Gracie W. Treatment of gallstones. Ann Intern Med ; 119 : - Halldestam I, Enell EL, Kullman E, et al. Development of symptoms and complications in individuals with asymptomatic
More informationFig. 3 59 years old, male. A case of common bile duct stone. Endoscopic picture shows that an ellipsoid stone exists in the common bile duct. Fig. 1 77 years old, female. A case of common bile duct stone.
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ESWL -, 174 -. Costamagna G, Gabbrielli A, Mutignani M, et al. Extracorporeal shock wave lithotripsy of pancreatic stones in chronic pancreatitis : immediate and medium-term results. Gastrointest Endosc
More information1) Delbet P: Retrocissement du choledoque. Cholecysto-duodenostomie. Bull Mem Soc Nat Chir 50: 1144-1146, 1924 2) Wiesner RH, LaRusso NF: Clinicopathologic Features of the Syndrome of Primary Sclerosing
More information1) Perissat J, Collet DR, Belliard R : Gallstones ; laparoscopic treatment, intracorporeal lithotripsy followed by cholecystotomy on cholecystectomy. Endoscopy 21 : 373-374, 1989 2) Kato K, Matsuda M,
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TP T-13i AST ALT ALP Y CTP LOH CHE CRP 8.7 id 0.4 mg/d 21 AWL 131U/L 257 LU/L 12 111/L 234 11J/L 344 IU/L 0.30 mid No K a BUN ORE UA 142 meq/1 4.3 meqa 108 meqa 15.8 met! 0.71 mg/di 5.0 mg/d CEA 5_5 n8/m1
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臨床研究 内視鏡的乳頭大口径バルーン拡張術 (EPLBD) における偶発症の検討 濱中紳策 鹿志村純也仁平武 要旨 : 内視鏡的乳頭大口径バルーン拡張術 (endoscopic papillary lange-balloon dilation: EPLBD) は, 径が大きく完全截石困難な総胆管結石に対する内視鏡的治療法として普及してきているが, 早期および晩期偶発症については, 現段階で評価できていない点が多い
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