췌관의 초음파 내시경 중재시술을 통한 랑데부 ERCP로 제거한 췌석 (Removal of Pancreatic Duct Stones by Endoscopic Ultrasonography-Guided Rendezvous ERCP)

서지정보

· 발행기관 : 대한내과학회
· 수록지 정보 : 대한내과학회지 / 92권 / 6호 / 533 ~ 536페이지
· 저자명 : 형례창, 김진영, 김하일, 박재철, 한지수, 전제혁, 김명환

초록

방사선 투과성 췌관 결석은 X선 투시를 결석 포착에 활용하는 ESWL 기계로는 시술 자체가 곤란하다. ERCP가 표준치료법이나 본 증례는 췌관 입구 협착이 심해 실패하였다.
ESWL과 ERCP가 모두 실패한 후 EUS 유도하 췌관 중재시술을 이용하여 ERCP 랑데부법을 시술하였으며 이를 통해성공적으로 방사성 투과성 췌관 결석을 제거할 수 있었다.

영어초록

Symptomatic pancreatic ductal stones can be removed nonsurgically by endoscopic retrograde cholangiopancreatography (ERCP), either alone or in combination with extracorporeal shock-wave lithotripsy (ESWL). Here, we report a case of successful endoscopic ultrasonography (EUS)-guided rendezvous ERCP for removal of radiolucent pancreatic stones after failed ERCP and ESWL. A 79-year-old male with painful chronic pancreatitis associated with pancreatic stones and a dilated upstream duct underwent transgastric antegrade pancreatography via EUS-guided pancreatic duct access followed by rendezvous ERCP. In this patient, EUS-guided rendezvous ERCP was successful in salvaging pancreatic duct cannulation after unsuccessful ERCP due to a tight stricture at the pancreatic duct orifice and removing radiolucent pancreatic stones after ESWL, which was unsuccessful because of failure to localize the stones due to their radiolucency under x-ray fluoroscopy.

참고자료

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