내시경적 접근이 어려운 담도 결석과 담도 폐쇄 환자에서 경피간담도 배액술과 경피적 풍선확장술: 단일 기관의 환자 21명에 대한 증례들

Background/Aim: The aim of this study was to evaluate the stability and simplicity of papillary balloon dilatation by retrospectively analyzing the results of performing concurrent papillary balloon dilatation in conjunction with percutaneous transhepatic biliary drainage (PTBD) in the patients with biliary obstruction due to common bile duct stones or a tumor who were difficult to treat with an endoscopic approach. Methods: We retrospectively analyzed a total of 21 patients who were treated through a percutaneous transhepatic biliary approach after they were diagnosed with biliary obstruction due to a tumor and biliary stones in a single medical institution for four years from 2012 to 2015. Results: Sixteen out of 21 patients (76.2%) underwent percutaneous transhepatic biliary drainage and papillary balloon dilatation. For 5 patients (23.8%) in whom it was difficult to perform the procedure simultaneously due to the patient's poor overall condition such as pancreatitis and septic shock, papillary balloon dilatation was performed 5-8 days after biliary drainage. Nineteen of 21 patients (90.5%) were successfully treated by a single procedure without residual stones or restenosis, but in two patients, stones were removed two times and three times. Conclusions: The use of a percutaneous transhepatic biliary approach to patients in whom endoscopy cannot be performed is considered safe and effective. In addition, unless the procedure is specifically contraindicated, the use of papillary balloon dilatation performed simultaneously with PTBD can reduce patient inconvenience and procedure frequency. [ABSTRACT FROM AUTHOR]