RESUMO
Successful performance of endoscopic sphincterotomy in the treatment of choledocholithiasis led to the placement of retrograde, transpapillary catheters for internal drainage and prevention of cholangitis. This technique presented the opportunity for using nasobiliary tubes for short term treatment of this problem or placing a permanent drain into the bile duct for long term management. Internal drains placed endoscopically have been used on 15 occasions: 10 nasobiliary and five permanent. These drains have functioned well without complications prompting us to recommend this approach in patients with benign or malignant obstruction of the biliary tree.
Assuntos
Colestase Intra-Hepática/terapia , Drenagem/métodos , Cateterismo/métodos , Colangiopancreatografia Retrógrada Endoscópica , Colangite/prevenção & controle , Colestase Intra-Hepática/diagnóstico , Drenagem/instrumentação , Endoscopia , HumanosRESUMO
Congenital cysts of the ble ducts and liver usually present with symptoms of compression, obstruction or infection. The management of these problems has been the surgical approach with extirpation or diversion techniques. Cysts of the common hepatic or bile ducts should be completely excised if possible while intrahepatic cysts are treated by anastomosis of the ducts to isolated intestinal loops. Diversion techniques for distal intraduodenal cysts leads to development of the sump syndrome, and, it has been our experience in two patients to treat these, choledochocele, by incision during performance of a sphincterotomy.
