Endoscopic Treatment of Bile Duct Calculi in Patients with Gallbladder in Situ / 대한소화기내시경학회지

BACKGROUND/AIMS: Endoscopic sphincterotomy (EST) is a safe and effective method of managing CBD calculi. But whether EST of CBD calculi in patients with gallbladder in situ should be followed by routine post-EST cholecystectomy, is still a subject of controversy. The aims of this study was to identify the recurrence rate and predictive factors of biliary symptoms after EST of CBD calculi in patients with gallbladder in situ. METHODS: 90 patients of CBD calculi with intact gallbladder treated with endoscopic sphincterotomy from 1992 to 1998 were reviewed. Follow up on the patients consisted of phone calls or personal interviews and the length of the follow up ranged from 6 to 77 months. RESULTS: Cholecystectomy was required in 12 patients (13.3%) due to recurrent biliary symptoms and the remaining 78 patients (86.6%) were symptom free. Of the recurrence, 67.7% occurred within 12 months after EST and only one occurred after 5 years of follow-up. The risk of recurrence was higher in those patients with periampullary diverticulum in ERCP. CONCLUSIONS: The low recurrence rate of 13.3% after EST of CBD stones in patients with gallbladder in situ hardly justifies routine post-EST cholecystectomy and rather suggests selective post-EST cholecystectomy especially in high operative risk patients.

Two cases of asymptomatic granular cell tumor of the bronchus detected incidentally by bronchoscopy / 결핵

Granular cell tumor(formerly named to be granular cell myoblastoma) was first described by Abrikossoff in 1926 and is a rare tumor thought to be of Schwann cell origin. It can occur at any soft tissue of the body, but most cases are found at the tongue, skin, breast and GI tract. Only 6% of them occur in respiratory system. We report two cases of asymptomatic granular cell tumor of the bronchus that were detected incidentally by bronchoscopy. One patient had aspiration pneumonia, the other had immotile cilia syndrome. The former patient was simply observed and bronchoscopic extirpation of the tumor was done in the latter patient.