Endoscopic ultrasound for choledocholithiasis in Billroth II altered anatomy
T. L. Silina,
Yu. B. Busyrev,
A. B. Shalygin,
A. S. Vorotyntsev,
A. Yu. Emelyanov,
A. A. Gvozdev,
K. N. Zhuravlev,
N. A. Rucheva,
A. V. Kameneva https://doi.org/10.31146/1682-8658-ecg-184-12-128-131
Abstract
Background and Objectives: Increasing application of EUSguided biliary drainage, however, does not determine the capabilities of complete EUSinvestigation of the common bile duct in patients with surgically altered upper gastrointestinal anatomy. The purpose of this study is to evaluate the specifi city and eff ectiveness of EUS for choledocholithiasis in a patient with Billroth II altered anatomy.
Patient and Methods: A 61-year-old female patient underwent a Billroth II gastric resection about 25 years ago. Choledocholithiasis was diagnosed a year ago. At the present examination, the results of ultrasound and MRCP were doubtful. Gastroscopy showed the ability to intubate the afferent limb with accessible papilla. EUS was performed to decide on further patient management.
Results: The common bile duct EUS-visualization was performed both from the gastric stump and from the afferent limb. The differences of intubating the afferent limb in comparison with the EGD, as well as the differences of the ultrasound picture in comparison with the traditional EUS of CBD were determined. Two CBD stones were detected by scanning from the afferent limb. ERCP was done in the same sedation session with balloon papilla dilatation and both stones lithoextraction. Laparoscopic cholecystectomy was performed on the second day without complications. The patient was discharged from the hospital on the fifth day after surgery. Within 10 months she feels well, no complaints.
Conclusions: EUS can be diagnostic method of choice for choledocholithiasis in patients with Billroth II altered anatomy if intubation of the afferent limb was confirmed endoscopically.
About the Authors
T. L. Silina
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”
Russian Federation
Russian Federation
Tatiana L. Silina, endosonographer, doctor of the endoscopy department
109240, Moscow, Yauzskaya st., 11
Yu. B. Busyrev
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”;
I. M. Sechenov First Moscow state medical Universit of the Ministry of health of the Russian Federation
Russian Federation
Russian Federation
Yuri B. Busyrev, deputy chief physician for surgery
Department of General surgery of the I. M. Sechenov First Moscow state medical University of the Ministry of health of the Russian Federation
109240, Moscow, Yauzskaya st., 11,
Trubetskaya St. 8/2, Moscow, 119991
A. B. Shalygin
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”;
I. M. Sechenov First Moscow state medical Universit of the Ministry of health of the Russian Federation
Russian Federation
Russian Federation
Anton B. Shalygin, head of the surgical department
Department of General surgery of the I. M. Sechenov First Moscow state medical University of the Ministry of health of the Russian Federation
109240, Moscow, Yauzskaya st., 11,
Trubetskaya St. 8/2, Moscow, 119991
A. S. Vorotyntsev
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”;
I. M. Sechenov First Moscow state medical Universit of the Ministry of health of the Russian Federation
Russian Federation
Russian Federation
Alexander S. Vorotyntsev, associate professor of general surgery
Department of General surgery of the I. M. Sechenov First Moscow state medical University of the Ministry of health of the Russian Federation
109240, Moscow, Yauzskaya st., 11,
Trubetskaya St. 8/2, Moscow, 119991
A. Yu. Emelyanov
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”;
I. M. Sechenov First Moscow state medical Universit of the Ministry of health of the Russian Federation
Russian Federation
Russian Federation
Andrei Yu. Emelyanov, associate professor of general surgery
Department of General surgery of the I. M. Sechenov First Moscow state medical University of the Ministry of health of the Russian Federation
109240, Moscow, Yauzskaya st., 11,
Trubetskaya St. 8/2, Moscow, 119991
A. A. Gvozdev
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”
Russian Federation
Russian Federation
Alexei A. Gvozdev, head of the endoscopy department
109240, Moscow, Yauzskaya st., 11
K. N. Zhuravlev
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”
Russian Federation
Russian Federation
Kirill N. Zhuravlev, head of the radiology department
109240, Moscow, Yauzskaya st., 11
N. A. Rucheva
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”
Russian Federation
Russian Federation
Natalia A. Rucheva, doctor of the radiology department
109240, Moscow, Yauzskaya st., 11
A. V. Kameneva
State budgetary institution of health care of the city of Moscow “I. V. Davydovsky City clinical hospital Of the Department of health of the city of Moscow”
Russian Federation
Russian Federation
Anastasia V. Kameneva, doctor of ultrasound diagnostics
109240, Moscow, Yauzskaya st., 11
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Review
For citations:
Silina T.L., Busyrev Yu.B., Shalygin A.B., Vorotyntsev A.S., Emelyanov A.Yu., Gvozdev A.A., Zhuravlev K.N., Rucheva N.A., Kameneva A.V. Endoscopic ultrasound for choledocholithiasis in Billroth II altered anatomy. Experimental and Clinical Gastroenterology. 2020;(12):128-131. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-184-12-128-131
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