J.Jpn. Surg. Soc.. 93(9): 1128-1131, 1992

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Report on the annual meeting

EVALUATION OF URGENT TREATMENT FOR IMPACTED BILE DUCT STONES

One hundred and forty-four urgent treatments for acute obstructive suppurative cholangitis (AOSC), acute obstructive cholangitis (AOC), or/and acute pancreatitis caused by impacted bile duct stones were performed for eight years from 1984 to 1991. The breakdown of these treatments are as follows.
Endoscopic decompression 103 cases 107 times
Endoscopic nasobiliary drainage (ENBD) 100
without sphincterotomy 65
with sphincterotomy 35
Endoscopic sphincterotomy (EST) 6
Pushing up 1
Percutaneous decompression 23 cases
Emergency operation 14 cases
It was not easy to diagnose every severe case of AOSC. As a result, however, endoscopy was very effective both in diagnosis and treatment. Concerning patients with thinner bile duct, endoscopic drainage was useful than percutaneous drainage. We prefer ENBD to EST followed by basket extraction of bile duct stones in an emergency state. ENBD is a rather easy technique even for beginners of ERCP, and is less invasive. The life-saving effect of ENBD is not inferior to that of EST.

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